| NPI | 1730395492 |
|---|---|
| Doing Business As | CASA DE MIMOSA |
| Entity Type | Organization |
| Authorized Contact | BRETT IAN COHEN COO 800-388-5150 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded (Licence: TX 001014271) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2023-03-04 |