Provider Demographics
NPI:1073754875
Name:SUPERIOR NURSING SERVICES, LLC
Entity Type:Organization
Organization Name:SUPERIOR NURSING SERVICES, LLC
Other - Org Name:SPECIALTY FOOT CARE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RN/SOLE PROPRIETOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:303-980-0015
Mailing Address - Street 1:21705 WHIRLAWAY AVE
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-3059
Mailing Address - Country:US
Mailing Address - Phone:303-980-0015
Mailing Address - Fax:720-542-3193
Practice Address - Street 1:21705 WHIRLAWAY AVE
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-3059
Practice Address - Country:US
Practice Address - Phone:303-980-0015
Practice Address - Fax:720-542-3193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO140522251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care