Healthcare Provider Details

I. General information

NPI: 1700010600
Provider Name (Legal Business Name): SUPERIOR HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2009
Last Update Date: 09/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 SEVERN AVE SUITE 8
METAIRIE LA
70002-3451
US

IV. Provider business mailing address

3501 SEVERN AVE SUITE 8
METAIRIE LA
70002-3451
US

V. Phone/Fax

Practice location:
  • Phone: 504-835-0565
  • Fax: 504-835-0985
Mailing address:
  • Phone: 504-835-0565
  • Fax: 504-835-0985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number025275
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number1412
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number1395
License Number StateLA

VIII. Authorized Official

Name: MRS. ELIZABETH ANN SPADAFORA
Title or Position: PRESIDENT
Credential: DC
Phone: 504-835-0565