MINGUS MOUNTAIN ESTATE RESIDENCIAL CENTER, INC. (NPI# 1891324711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891324711 |
| Entity Type | Organization |
| Organization Name | MINGUS MOUNTAIN ESTATE RESIDENCIAL CENTER, INC. |
| Practice Address |
1120 E 6th St Casa Grande AZ 85122-4206 |
| Practice Telephone | 7143176552 |
| Mailing Telephone | 7143176552 |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2020-04-02 |
| Authorized Official Name | FRED RICHMOND (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7143176552 |
| Is Organization Subpart | Y |
| Parent Organization Name | MINGUS MOUNTAIN ESTATE RESIDENCIAL CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Casa Grande Academy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467654814 | Mingus Mountain Estate Residencial Center, Inc. | Assisted Living Facility | Hc 76 Hwy 89 A N Junction 151, Prescott Valley, AZ 86312-6485 | 2007-06-05 |
| Street Address |
1120 E 6TH ST |
| City | CASA GRANDE |
| State | AZ |
| Zip Code | 85122-4206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649371253 | Southwestern Children's Health Services, Inc. | Psychiatric Residential Treatment Facility | 1120 E 6th St, Casa Grande, AZ 85222 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043857097 | Karen M Garcia | Registered Nurse | 2631 N Brown Avenue, Casa Grande, AZ 85122 | 2019-12-09 |
| 1063060291 | Martha Bollin | Registered Nurse | 2631 N. Brown Ave., Casa Grande, AZ 85122 | 2019-08-30 |
| 1841846920 | Banner Imaging Services LLC | Radiology | 1828 E. Florence Blvd Bldg B Ste 118 & 128, Suite 118 and 128, Casa Grande, AZ 85122 | 2019-08-14 |
| 1629532692 | Kirk Lee Mackley | Physical Therapist | Vibrant Care, 1355 E Florence Blvd #137, Casa Grande, AZ 85122 | 2019-01-24 |
| 1205307436 | Natalie T Trujillo | Physician Assistant | 301 E Cottonwood Ln Ste 1&2, Casa Grande, AZ 85122 | 2018-12-16 |
| 1710455860 | Community Intervention Associates, Inc | Clinic/Center | 1667 N. Trekell Rd, Suite 101 & 102, Casa Grande, AZ 85122 | 2018-11-07 |
| 1245728302 | Jenkins Chiropractic LLC | Chiropractor | 1891 N Trekell Rd Ste 2, Casa Grande, AZ 85122 | 2018-04-24 |
| 1497242408 | Kelly Winnett | Naturopath | 1415 N Trekell Rd Ste 102, Casa Grande, AZ 85122 | 2018-04-16 |
| 1851895783 | Michael Brubaker Counseling | Community/Behavioral Health | 1927 N. Trekell Rd, Ste D, Casa Grande, AZ 85122 | 2018-03-23 |
| 1770095317 | Walmart Stores Inc. | Pharmacy | 1741 E. Florence Blvd, Casa Grande, AZ 85122 | 2017-11-03 |
| Find all providers in zip 85122 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386065159 | Olive Branch, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 411 W 9th St, Casa Grande, AZ 85122-3204 | 2013-12-23 |
| 1285876110 | New Horizon Youth Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 395 E Settlers Trl, Casa Grande, AZ 85222-8790 | 2009-03-24 |
| 1841404852 | New Horizon Youth Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 467 East Dragon Springs Dr, Casa Grande, AZ 85222 | 2007-05-09 |
| 1790225183 | Zion R&r International | Residential Treatment Facility, Emotionally Disturbed Children | 304 E 3rd St, Casa Grande, AZ 85122-5224 | 2017-03-03 |
| 1235532060 | Successful Livings LLC | Residential Treatment Facility, Emotionally Disturbed Children | 304 N Lincoln Ave, Casa Grande, AZ 85122-4634 | 2014-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528666039 | Rehoboth LLC | Residential Treatment Facility, Emotionally Disturbed Children | 46136 W Mountain View Rd # A, Maricopa, AZ 85139-6796 | 2020-10-16 |
| 1962022665 | New Hope of Arizona, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8710 W Watkins St, Tolleson, AZ 85353-9028 | 2020-04-22 |
| 1639798143 | Anthony Udoinwang | Residential Treatment Facility, Emotionally Disturbed Children | 10435 W Reade Ave, Glendale, AZ 85307-4237 | 2020-04-14 |
| 1033756358 | Native Music Coalition | Residential Treatment Facility, Emotionally Disturbed Children | 5150 S Crazy Cat Ln, Tucson, AZ 85735 | 2019-12-05 |
| 1013558311 | Back To Life Incorporated | Residential Treatment Facility, Emotionally Disturbed Children | 6420 W Cocopah St, Phoenix, AZ 85043 | 2019-10-08 |
| 1487118865 | Serenity Preferred LLC | Residential Treatment Facility, Emotionally Disturbed Children | 17829 W Columbine Dr, Surprise, AZ 85388-5628 | 2019-01-30 |
| 1407333958 | Copa's Caring Hands LLC. | Residential Treatment Facility, Emotionally Disturbed Children | 42251 W Bravo Dr, Maricopa, AZ 85138-2295 | 2018-07-26 |
| 1538668983 | Starks Homes LLC | Residential Treatment Facility, Emotionally Disturbed Children | 7325 E Fayette St, Tucson, AZ 85730-2324 | 2018-02-12 |
| 1881100147 | Anna Marie Barrios | Residential Treatment Facility, Emotionally Disturbed Children | 18811 N 7th Dr, Phoenix, AZ 85027-5508 | 2017-12-22 |
| 1033625926 | Youth Transition Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1190 S Boulder St Unit D, Gilbert, AZ 85296-3792 | 2017-12-14 |
| Find all providers with the same taxonomy | ||||
| City | CASA GRANDE |
| Zip Code | 85122 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.