Provider Demographics
NPI:1972183101
Name:SUPERB HOME HEALTHCARE AGENCY LLC
Entity Type:Organization
Organization Name:SUPERB HOME HEALTHCARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-871-1571
Mailing Address - Street 1:7880 N UNIVERSITY DR STE 302
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2124
Mailing Address - Country:US
Mailing Address - Phone:954-871-1571
Mailing Address - Fax:
Practice Address - Street 1:7880 N UNIVERSITY DR STE 302
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2124
Practice Address - Country:US
Practice Address - Phone:305-613-6656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities