Healthcare Provider Details

I. General information

NPI: 1629823307
Provider Name (Legal Business Name): SMC CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2024
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 3RD AVE SW
FARIBAULT MN
55021-6038
US

IV. Provider business mailing address

771 INDIAN TRL S
AFTON MN
55001-9704
US

V. Phone/Fax

Practice location:
  • Phone: 507-332-0547
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: ROGER BONNY
Title or Position: PRESIDENT
Credential:
Phone: 860-967-9340