Provider Demographics
NPI:1629750229
Name:SUPERIOR HOME CARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:SUPERIOR HOME CARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:RIVERSON
Authorized Official - Last Name:OKAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-320-3147
Mailing Address - Street 1:1142 FOUR SEASONS DR APT 1
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-9207
Mailing Address - Country:US
Mailing Address - Phone:419-320-3147
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:1142 FOUR SEASONS DR APT 1
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-9207
Practice Address - Country:US
Practice Address - Phone:419-320-3147
Practice Address - Fax:000-000-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care