Provider Demographics
NPI:1609016260
Name:SUPERIOR GERIATRIC SERVICES, INC
Entity Type:Organization
Organization Name:SUPERIOR GERIATRIC SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:NOELINA
Authorized Official - Last Name:BEAUSOLEIL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-773-9115
Mailing Address - Street 1:9555 W SAM HOUSTON PKWY S
Mailing Address - Street 2:SUITE 315
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-2132
Mailing Address - Country:US
Mailing Address - Phone:713-773-9115
Mailing Address - Fax:713-773-9968
Practice Address - Street 1:9555 W SAM HOUSTON PKWY S
Practice Address - Street 2:SUITE 315
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-2132
Practice Address - Country:US
Practice Address - Phone:713-773-9115
Practice Address - Fax:713-773-9968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-23
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care