Provider Demographics
NPI:1083832182
Name:SUPERIOR OPTIONS OF LA INC
Entity Type:Organization
Organization Name:SUPERIOR OPTIONS OF LA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BLASINA
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-367-9572
Mailing Address - Street 1:1799 STUMPF BLVD
Mailing Address - Street 2:BLDG 7 SUITE 9B
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056-3950
Mailing Address - Country:US
Mailing Address - Phone:504-367-9572
Mailing Address - Fax:504-367-9573
Practice Address - Street 1:1799 STUMPF BLVD
Practice Address - Street 2:BLDG 7 SUITE 9B
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-3950
Practice Address - Country:US
Practice Address - Phone:504-367-9572
Practice Address - Fax:504-367-9573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA82943747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1530824Medicaid