Provider Demographics
NPI:1649088964
Name:MIMI HEALTHCARE SOLUTIONS, LLC
Entity type:Organization
Organization Name:MIMI HEALTHCARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:MELISSA
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:267-971-6063
Mailing Address - Street 1:204 MACDONALD AVE
Mailing Address - Street 2:
Mailing Address - City:WYNCOTE
Mailing Address - State:PA
Mailing Address - Zip Code:19095-2403
Mailing Address - Country:US
Mailing Address - Phone:267-971-6063
Mailing Address - Fax:
Practice Address - Street 1:5234 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19139-3414
Practice Address - Country:US
Practice Address - Phone:267-625-8263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities