NPIMap

Organization Active NPI

Kimberly'S Residential Care Home

  • Mental Illness Community Based Residential Treatment Facility
  • Rancho Cordova, CA
National Provider Identifier
1063599538
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
KIMBERLY'S RESIDENTIAL CARE HOME
Practice address
10514 Mills Tower Dr
Rancho Cordova, CA 95670-5517
Phone
(916) 362-4473
Fax
(916) 362-4473
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mike G Tampus
Title
Owner
Phone
(916) 631-7969

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X CA Primary

Addresses

Primary practice location

10514 Mills Tower Dr
Rancho Cordova, CA 95670-5517

Mailing address

2218 Bucks Creek CT
Gold River, CA 95670-8121
Phone (916) 631-7969

National Provider Directory

National Provider Directory
Tax ID family
Kimberly Beverly'S Guest Home3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063599538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 BUCKS CREEK CT",
            "city": "GOLD RIVER",
            "state": "CA",
            "postal_code": "956708121",
            "telephone_number": "916-631-7969",
            "fax_number": "916-638-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10514 MILLS TOWER DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956705517",
            "telephone_number": "916-362-4473",
            "fax_number": "916-362-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY'S RESIDENTIAL CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TAMPUS",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-631-7969"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.