Provider Demographics
NPI:1568973154
Name:SUPERIOR LIVING HOMES, LLC
Entity Type:Organization
Organization Name:SUPERIOR LIVING HOMES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-489-6995
Mailing Address - Street 1:10699 CRABAPPLE LN
Mailing Address - Street 2:
Mailing Address - City:RIVES JUNCTION
Mailing Address - State:MI
Mailing Address - Zip Code:49277-9746
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10699 CRABAPPLE LN
Practice Address - Street 2:
Practice Address - City:RIVES JUNCTION
Practice Address - State:MI
Practice Address - Zip Code:49277-9746
Practice Address - Country:US
Practice Address - Phone:517-489-6995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174200000X, 177F00000X, 251C00000X, 251E00000X, 253Z00000X
MI376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376G00000XNursing Service Related ProvidersNursing Home AdministratorGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care