Provider Demographics
NPI:1851086821
Name:SUPERIOR QUALITY HOME CARE LLC
Entity Type:Organization
Organization Name:SUPERIOR QUALITY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHATERIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODBURY
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:786-704-4839
Mailing Address - Street 1:4461 NW 173RD DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-3707
Mailing Address - Country:US
Mailing Address - Phone:786-704-4839
Mailing Address - Fax:
Practice Address - Street 1:4461 NW 173RD DR
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-3707
Practice Address - Country:US
Practice Address - Phone:786-704-4839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care