Provider Demographics
NPI:1780844027
Name:ZIMCARE FOSTER CARE HOMES LLC
Entity Type:Organization
Organization Name:ZIMCARE FOSTER CARE HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SIBONGINKOSI
Authorized Official - Middle Name:
Authorized Official - Last Name:OSEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-806-5459
Mailing Address - Street 1:1339 KINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-5101
Mailing Address - Country:US
Mailing Address - Phone:269-806-5459
Mailing Address - Fax:
Practice Address - Street 1:600 DARBY LN
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-2651
Practice Address - Country:US
Practice Address - Phone:269-383-5926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS390272314320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness