Mims Family Care Home

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

FCL092045 Issued in NC

Legal business name

MIMS FAMILY CARE HOME

Practice address

6337 Mims Rd
Holly Springs, NC 27540-9559

Phone

(919) 552-6455

NPI assigned

Sep 19, 2007

Organization subpart

No

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

Authorized official

Name

Joyce Mims

Title

Administrator

Phone

(919) 552-6455

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190160000000",
    "number": "1851587331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6337 MIMS RD",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275409559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6337 MIMS RD",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275409559",
            "telephone_number": "919-552-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIMS FAMILY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2007-09-19",
        "status": "A",
        "authorized_official_last_name": "MIMS",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-552-6455"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "FCL092045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7801930",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Isha Manohar Mehta, M.D.
• Amanda Ward Meisel, CNM
• Kayla Merkel, LCSW
• Robin Elaine Kennel Miller, MS, LAT, ATC, CSCS
• Mims Family Care Home
• Michelle Pamela Mishenko
• MMS Unlimited
• Modern Health Institute PC
• Sweety Mody
• Dalia Magzoub Mohamed, DMD

• Mental Illness Community Based Residential Treatment Facility in Holly Springs, NC
• Providers in Holly Springs, NC by specialty
• Mental Illness Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.