# MIMIS HOMES,INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396831475
- **Authorized official:** MRS. RAQUEL MONTERO RN (PRESIDENT)
- **Authorized official phone:** (562) 682-1484

## Contact information

- **Practice address:** 7142 DE PALMA ST, DOWNEY, CA 90241-4386
- **Practice address phone:** (562) 806-9640
- **Mailing address:** 7142 DE PALMA ST, DOWNEY, CA 90241-4386
- **Mailing address phone:** (562) 806-9640
- **Mailing address fax:** (562) 806-9640

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | CA | Yes |

## Other

- **Enumeration date:** 10/05/2006
- **Last updated:** 08/27/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | LTC 60880F | MEDICAL PROVIDER NUMBER | CA |