Provider Demographics
NPI:1629823307
Name:SMC CARE, INC.
Entity Type:Organization
Organization Name:SMC CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:BONNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-967-9340
Mailing Address - Street 1:771 INDIAN TRL S
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:MN
Mailing Address - Zip Code:55001-9704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4 3RD AVE SW
Practice Address - Street 2:
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-6038
Practice Address - Country:US
Practice Address - Phone:507-332-0547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility