Provider Demographics
NPI:1023517885
Name:SUPERIOR MOBILE AIDES
Entity type:Organization
Organization Name:SUPERIOR MOBILE AIDES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-659-0216
Mailing Address - Street 1:131 COMMERCIAL DR # 3
Mailing Address - Street 2:
Mailing Address - City:STUTTGART
Mailing Address - State:AR
Mailing Address - Zip Code:72160-7033
Mailing Address - Country:US
Mailing Address - Phone:870-659-0216
Mailing Address - Fax:
Practice Address - Street 1:131 COMMERCIAL DR # 3
Practice Address - Street 2:
Practice Address - City:STUTTGART
Practice Address - State:AR
Practice Address - Zip Code:72160-7033
Practice Address - Country:US
Practice Address - Phone:870-659-0216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-07
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care