Provider Demographics
NPI:1962880278
Name:SUPERIOR HOME CARE,INC
Entity type:Organization
Organization Name:SUPERIOR HOME CARE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARGRAVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-647-9662
Mailing Address - Street 1:1408 N LONG ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-3740
Mailing Address - Country:US
Mailing Address - Phone:704-647-9662
Mailing Address - Fax:704-647-9663
Practice Address - Street 1:1709 N LONG ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-3743
Practice Address - Country:US
Practice Address - Phone:704-647-9662
Practice Address - Fax:704-647-9663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-07
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1548565591OtherCAP
NC1104991462Medicaid