Provider Demographics
NPI:1275920415
Name:SMOOKA BEAR HOME HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:SMOOKA BEAR HOME HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF EXECUTIVE
Authorized Official - Prefix:MS
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PENROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-787-7306
Mailing Address - Street 1:112 ROSALIND PLACE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43610
Mailing Address - Country:US
Mailing Address - Phone:419-787-7306
Mailing Address - Fax:
Practice Address - Street 1:112 ROSALIND PL
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43610-1536
Practice Address - Country:US
Practice Address - Phone:419-787-7306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No251E00000XAgenciesHome Health