Provider Demographics
NPI:1851134191
Name:SIMBA HOME HEALTH LLC
Entity type:Organization
Organization Name:SIMBA HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:IRINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-942-2717
Mailing Address - Street 1:4100 BRIDGEWATER PKWY APT 201
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-6102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4100 BRIDGEWATER PKWY APT 201
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-6102
Practice Address - Country:US
Practice Address - Phone:330-942-2717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services