Provider Demographics
NPI:1700010600
Name:SUPERIOR HEALTHCARE, LLC
Entity Type:Organization
Organization Name:SUPERIOR HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SPADAFORA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:504-835-0565
Mailing Address - Street 1:3501 SEVERN AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-3451
Mailing Address - Country:US
Mailing Address - Phone:504-835-0565
Mailing Address - Fax:504-835-0985
Practice Address - Street 1:3501 SEVERN AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3451
Practice Address - Country:US
Practice Address - Phone:504-835-0565
Practice Address - Fax:504-835-0985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1412111NR0400X
LA1395111NR0400X
LA025275208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA6440030001Medicare NSC
LA5DU06Medicare UPIN