Provider Demographics
NPI:1548565591
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 / OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:LORETTA
Authorized Official - Last Name:HARGRAVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-647-9662
Mailing Address - Street 1:1709 N. LONG STREET
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144
Mailing Address - Country:US
Mailing Address - Phone:704-647-9662
Mailing Address - Fax:704-647-9663
Practice Address - Street 1:1709 N. LONG STREET
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144
Practice Address - Country:US
Practice Address - Phone:704-647-9662
Practice Address - Fax:704-647-9663
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUPERIOR HOME CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-24
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
NC3418720Medicaid