Provider Demographics
NPI:1518964618
Name:SUPERIOR HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:SUPERIOR HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALITIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:570-883-9581
Mailing Address - Street 1:224 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DUPONT
Mailing Address - State:PA
Mailing Address - Zip Code:18641-2014
Mailing Address - Country:US
Mailing Address - Phone:570-883-9581
Mailing Address - Fax:570-883-7001
Practice Address - Street 1:224 MAIN ST
Practice Address - Street 2:
Practice Address - City:DUPONT
Practice Address - State:PA
Practice Address - Zip Code:18641-2014
Practice Address - Country:US
Practice Address - Phone:570-883-9581
Practice Address - Fax:570-883-7001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA752105251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01272785Medicaid
PA1JOtherBLUE CROSS
PA806265OtherFIRST PRIORITY
PA01272785Medicaid