Provider Demographics
NPI:1720711997
Name:BEAR HOME HEALTH
Entity Type:Organization
Organization Name:BEAR HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:RAYANN
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:916-764-9193
Mailing Address - Street 1:2110 S PLATEAU DR
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-4706
Mailing Address - Country:US
Mailing Address - Phone:916-764-9193
Mailing Address - Fax:
Practice Address - Street 1:2110 S PLATEAU DR
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-4706
Practice Address - Country:US
Practice Address - Phone:916-764-9193
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care