Organization
MIMIS HOMES,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RAQUEL MONTERO RN (PRESIDENT)
(562) 682-1484
Entity
Organization
Contact information
Practice address
7142 DE PALMA ST, DOWNEY, CA 90241-4386
(562) 806-9640
Mailing address
7142 DE PALMA ST, DOWNEY, CA 90241-4386
(562) 806-9640
(562) 806-9640
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LTC 60880F
MEDICAL PROVIDER NUMBER
CA
Enumeration date
10/05/2006
Last updated
08/27/2007
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