Provider Demographics
NPI:1699805820
Name:SUPERIOR HEALTH CARE INC
Entity type:Organization
Organization Name:SUPERIOR HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LIONEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-463-0123
Mailing Address - Street 1:10608 SNOWHEIGHTS BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-3012
Mailing Address - Country:US
Mailing Address - Phone:505-463-0123
Mailing Address - Fax:505-332-8942
Practice Address - Street 1:10608 SNOWHEIGHTS BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-3012
Practice Address - Country:US
Practice Address - Phone:505-463-0123
Practice Address - Fax:505-332-8942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM53474864Medicaid