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General NPI Number Information
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NPI Number | 1164850681
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Entity Type | Organization
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Legal Business Name | VALERIE A. JOHNSON DBA MAMA BEAR IN HOME CARE
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Dates
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Enumeration Date | 10/18/2013
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Last Update Date | 04/01/2019
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Provider Practice Location Address
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Address Line | 3068 HUDSON RD
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City | HUDSON
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State | ME
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Zip | 04449-3041
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Country | US
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Telephone | 207-949-6627
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Fax |
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Provider Business Mailing Address
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Address Line | 3068 HUDSON RD
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City | HUDSON
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State | ME
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Zip | 04449-3041
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Country | US
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Telephone | 207-949-6627
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. VALERIE ANN JOHNSON
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Credential |
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Telephone | 207-949-6627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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