Organization
KIMBERLY'S RESIDENTIAL CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE G TAMPUS (OWNER)
(916) 631-7969
Entity
Organization
Contact information
Practice address
10514 MILLS TOWER DR, RANCHO CORDOVA, CA 95670-5517
(916) 362-4473
(916) 362-4473
Mailing address
2218 BUCKS CREEK CT, GOLD RIVER, CA 95670-8121
(916) 631-7969
(916) 638-8880
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
CA
Other
Enumeration date
11/01/2006
Last updated
08/22/2020
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