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MINGUS MOUNTAIN ESTATE RESIDENTIAL CENTER INC NPI 1114090925


NPI Information

NPI: 1114090925
Provider Name: MINGUS MOUNTAIN ESTATE RESIDENTIAL CENTER INC

Other Name: FARRINGTON HOUSE

Classification: Assisted Living Facility - 3104A0630X
Entity Type: Organization

Specialization: Assisted Living, Behavioral Disturbances

Address:
100 DEWEY ROAD
FARRINGTON HOME
DEWEY, AZ
ZIP 86327
Phone: (602) 335-2095
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MINGUS MOUNTAIN ESTATE RESIDENTIAL CENTER INC is an assisted living and behavioral disturbances assisted living facility in Dewey, AZ. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. MINGUS MOUNTAIN ESTATE RESIDENTIAL CENTER INC NPI is 1114090925. The provider is registered as an organization entity type.
The provider Other Name Is Farrington House.

The provider's business location address is:

100 DEWEY ROAD
FARRINGTON HOME
DEWEY, AZ
ZIP 86327
Phone: (602) 335-2095
Fax: (602) 249-1311

The provider's authorized official is Chris Banken .
The authorized official title is Executive Director and has the following contact phone number (602) 335-2095.

The enumeration date for this NPI number is 11/17/2006 and was last updated on 7/8/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13104A0630XAssisted Living FacilityAssisted Living, Behavioral DisturbancesBH-1122ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1497744MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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