Organization
MIMS FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOYCE MIMS (ADMINSTRATOR)
(919) 552-6455
Entity
Organization
Contact information
Practice address
6401 MIMS RD, HOLLY SPRINGS, NC 27540-9561
(919) 552-6455
(919) 567-5313
Mailing address
6401 MIMS RD, HOLLY SPRINGS, NC 27540-9561
(919) 552-6455
(919) 567-5313
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL092045
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801930
—
NC
Enumeration date
06/20/2007
Last updated
09/04/2007
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