# KIMBERLY'S RESIDENTIAL CARE HM

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

## Provider details

- **NPI number:** 1902969884
- **Authorized official:** MIKE G TAMPUS (OWNER)
- **Authorized official phone:** (916) 631-7969

## Contact information

- **Practice address:** 10514 MILLS TOWER DRIVE, RANCHO CORDOVA, CA 95670
- **Practice address phone:** (916) 362-4473
- **Practice address fax:** (916) 362-4473
- **Mailing address:** 2218 BUCKS CREEK COURT, GOLD RIVER, CA 95670
- **Mailing address phone:** (916) 631-7969
- **Mailing address fax:** (916) 638-8880

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 340309353 | CA | Yes |

## Other

- **Enumeration date:** 12/19/2006
- **Last updated:** 06/24/2008