Provider Demographics
NPI:1164850681
Name:VALERIE A. JOHNSON DBA MAMA BEAR IN HOME CARE
Entity Type:Organization
Organization Name:VALERIE A. JOHNSON DBA MAMA BEAR IN HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-949-6627
Mailing Address - Street 1:3068 HUDSON RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:ME
Mailing Address - Zip Code:04449-3041
Mailing Address - Country:US
Mailing Address - Phone:207-949-6627
Mailing Address - Fax:
Practice Address - Street 1:3068 HUDSON RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:ME
Practice Address - Zip Code:04449-3041
Practice Address - Country:US
Practice Address - Phone:207-949-6627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-18
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care