Provider Demographics
NPI:1144388414
Name:SUPERIOR HEALTH CARE
Entity Type:Organization
Organization Name:SUPERIOR HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-256-0323
Mailing Address - Street 1:PO BOX 66054
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-9408
Mailing Address - Country:US
Mailing Address - Phone:515-256-0323
Mailing Address - Fax:515-537-1051
Practice Address - Street 1:7725 WISTFUL VISTA DR
Practice Address - Street 2:UNIT 703
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8032
Practice Address - Country:US
Practice Address - Phone:515-256-0323
Practice Address - Fax:515-537-1051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2008-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA36932OtherWELLMARK
IA0469429Medicaid
IA33142OtherWELLMARK
IA42385Medicare ID - Type Unspecified