Provider Demographics
NPI:1316430937
Name:KIMMONS CARE INC.
Entity type:Organization
Organization Name:KIMMONS CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:901-246-5376
Mailing Address - Street 1:1636 SUMMER CITY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-3418
Mailing Address - Country:US
Mailing Address - Phone:901-246-5376
Mailing Address - Fax:
Practice Address - Street 1:7102 BROOKSIDE RD STE 102
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-7324
Practice Address - Country:US
Practice Address - Phone:901-246-5376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-08
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services