Provider Demographics
NPI:1164186110
Name:BEAR PAW ENTERPRISES, LLC
Entity Type:Organization
Organization Name:BEAR PAW ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WORK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-587-0005
Mailing Address - Street 1:955 CLEVELAND AVE SW
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-3737
Mailing Address - Country:US
Mailing Address - Phone:320-587-0005
Mailing Address - Fax:320-587-0053
Practice Address - Street 1:1025 DALE ST SW
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-3065
Practice Address - Country:US
Practice Address - Phone:320-234-8917
Practice Address - Fax:320-587-0053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA347107300Medicaid
MNA836907200Medicaid