Provider Demographics
NPI:1033344908
Name:SMILE NURSING CARE, INC
Entity Type:Organization
Organization Name:SMILE NURSING CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELENA
Authorized Official - Middle Name:C
Authorized Official - Last Name:JALLAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-531-8117
Mailing Address - Street 1:5901 BROOKLYN BLVD STE 212
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55429-2533
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5901 BROOKLYN BLVD STE 212
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-2533
Practice Address - Country:US
Practice Address - Phone:763-531-8117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN040206003OtherMETROPOLITAN HEALTH PLAN