Provider Demographics
NPI:1013503259
Name:SUPERIOR HOME CARE SERVICES, INC
Entity Type:Organization
Organization Name:SUPERIOR HOME CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ-MANSILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-505-1366
Mailing Address - Street 1:PO BOX 2295
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92018-2295
Mailing Address - Country:US
Mailing Address - Phone:760-814-9930
Mailing Address - Fax:760-400-0976
Practice Address - Street 1:2182 S EL CAMINO REAL STE 205
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6207
Practice Address - Country:US
Practice Address - Phone:760-814-9930
Practice Address - Fax:760-400-0976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA374700087OtherDEPARTMENT OF SOCIAL SERVICES, HOME CARE DIVISION