Provider Demographics
NPI:1013442409
Name:SUPERIOR HEALTH AND HUMAN SERVICES OF MN
Entity Type:Organization
Organization Name:SUPERIOR HEALTH AND HUMAN SERVICES OF MN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTENSIA
Authorized Official - Middle Name:NENG
Authorized Official - Last Name:LARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:651-239-8191
Mailing Address - Street 1:1973 SLOAN PL
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55117-2084
Mailing Address - Country:US
Mailing Address - Phone:651-705-8723
Mailing Address - Fax:651-212-4003
Practice Address - Street 1:1973 SLOAN PL
Practice Address - Street 2:SUITE 210
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55117-2084
Practice Address - Country:US
Practice Address - Phone:651-705-8723
Practice Address - Fax:651-212-4003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty