Provider Demographics
NPI:1316516115
Name:SUPERIOR HOMES LLC
Entity type:Organization
Organization Name:SUPERIOR HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABDINOOR
Authorized Official - Middle Name:H
Authorized Official - Last Name:FARAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-594-5123
Mailing Address - Street 1:8220 MITCHELL RD
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-1500
Mailing Address - Country:US
Mailing Address - Phone:195-259-4512
Mailing Address - Fax:
Practice Address - Street 1:8220 MITCHELL RD
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55347-1500
Practice Address - Country:US
Practice Address - Phone:195-259-4512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty