MEDICARE: SIMONE VANESSA MCBRIDE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	253Z00000X	In Home Supportive Care Agency	OH
2	253Z00000X	In Home Supportive Care Agency
3	385H00000X	Respite Care

General Provider Information

NPI Number	:	1386417228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMONE VANESSA MCBRIDE

Provider Business Mailing Address
First Line	:	1611 GOULD RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43612-2022
Country	:	US
Telephone Number	:	419-343-8971
Fax Number	:

Provider Business Practice Location Address
First Line	:	1611 GOULD RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43612-2022
Country	:	US
Telephone Number	:	419-343-8971
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2023
Last Update Date	:	01/27/2025

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Directions to “ SIMONE VANESSA MCBRIDE ” Practice Location

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