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General NPI Number Information
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NPI Number | 1649088964
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Entity Type | Organization
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Legal Business Name | MIMI HEALTHCARE SOLUTIONS, LLC
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 5234 CHESTNUT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19139-3414
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Country | US
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Telephone | 267-625-8263
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Fax |
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Provider Business Mailing Address
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Address Line | 204 MACDONALD AVE
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City | WYNCOTE
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State | PA
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Zip | 19095-2403
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Country | US
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Telephone | 267-971-6063
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. NATALIE MELISSA WALKER
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Credential | MSW
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Telephone | 267-971-6063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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