Provider Demographics
NPI:1316763469
Name:MS.MIMI CARING HEART LLC
Entity type:Organization
Organization Name:MS.MIMI CARING HEART LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIRLANDE
Authorized Official - Middle Name:
Authorized Official - Last Name:BONNE-ANNEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-647-3500
Mailing Address - Street 1:3466 W SUNSHINE BUTTE DR
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85144-3058
Mailing Address - Country:US
Mailing Address - Phone:602-616-0039
Mailing Address - Fax:
Practice Address - Street 1:3466 W SUNSHINE BUTTE DR
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85144-3058
Practice Address - Country:US
Practice Address - Phone:602-616-0039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No251K00000XAgenciesPublic Health or Welfare
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child