Organization
MIMS FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOYCE MIMS (ADMINISTRATOR)
(919) 552-6455
Entity
Organization
Contact information
Practice address
6337 MIMS RD, HOLLY SPRINGS, NC 27540-9559
(919) 552-6455
Mailing address
6337 MIMS RD, HOLLY SPRINGS, NC 27540-9559
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
FCL092045
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801930
—
NC
Enumeration date
09/19/2007
Last updated
09/19/2007
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