MARY'S MISSION & DEVELOPMENTAL CENTER, INC
NPI: 1083725832
· SIERRA VISTA, AZ 85635
· Emotionally Disturbed Childrens' Residential Treatment Facility
· NPI assigned 08/31/2006
$2.43M
Total Medicaid Paid
Provider Details
| Authorized Official | LACEY, WILLIAM (CEO/ADMINISTRATOR) |
| NPI Enumeration Date | 08/31/2006 |
Related Entities
Other providers sharing the same authorized official: LACEY, WILLIAM
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
| 2018 |
123 |
$346K |
| 2019 |
167 |
$366K |
| 2020 |
519 |
$708K |
| 2021 |
790 |
$585K |
| 2023 |
153 |
$427K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
| H0018 |
Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem |
1,100 |
586 |
$2.35M |
| H2016 |
Comprehensive community support services, per diem |
652 |
118 |
$79K |