Mimshack Care Homes LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

MIMSHACK CARE HOMES LLC

Practice address

12330 Springcrest Dr
Houston, TX 77072-3219

Phone

(832) 277-2618

NPI assigned

Oct 21, 2020

Organization subpart

No

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

Authorized official

Name

Chinyere Agbafor

Title

C.E.O/Program Manager

Phone

(832) 277-2618

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1750980686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12330 SPRINGCREST DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770723219",
            "telephone_number": "832-277-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12330 SPRINGCREST DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770723219",
            "telephone_number": "832-277-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIMSHACK CARE HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "AGBAFOR",
        "authorized_official_first_name": "CHINYERE",
        "authorized_official_title_or_position": "C.E.O/PROGRAM MANAGER",
        "authorized_official_telephone_number": "832-277-2618"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mimis Caring Angels Corporation
• Cristina Mims, RN
• Martha Pritchett Mims, MD
• Maurice Mims
• Shunda Mims, LVN
• Min-Shern Liu D. O., P.a.
• Juleen Min, MD
• Seonghong Min, PHD
• Stella Min
• Sur J. Min, RN, CNS, ANP APRN BC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Houston, TX
• Providers in Houston, TX by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.