Kimberly & Beverly's Guest Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

340312905 Issued in CA

Legal business name

KIMBERLY & BEVERLY'S GUEST HOME

Practice address

10100 Countryside Way
Sacramento, CA 95827-5517

Phone

(916) 366-3111

Fax

(916) 638-8880

NPI assigned

Dec 20, 2006

Last updated

Jun 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mike G Tampus

Title

Owner

Phone

(916) 631-7969

Specialties & licenses 1

Addresses

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.

• Kimberly's Residential Care HM

  • Adult Care Home Facility
  • Rancho Cordova, CA
  • NPI 1902969884
  NPD tax ID
• Kimberly's Residential Care Home

  • Mental Illness Community Based Residential Treatment Facility
  • Rancho Cordova, CA
  • NPI 1063599538
  NPD tax ID

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1376607929",
    "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": "10100 COUNTRYSIDE WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958275517",
            "telephone_number": "916-366-3111",
            "fax_number": "916-638-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY & BEVERLY'S GUEST HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2008-06-24",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "CA",
            "license": "340312905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Kimathi, BS
• Benita Kimball, CMF
• Isabella Kimball
• Kilianne Rhea Kimball, PH.D..
• William R. Kimball, MD
• Christina Kimble
• Destiny Dawn Kimmel, NP
• Maria Kimmel
• Amy Elizabeth Kimmons, CPSP
• Robyn L Kimura, M.D.

• Adult Care Home Facility in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Adult Care Home Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.