Healthcare Provider Details
I. General information
NPI: 1427246719
Provider Name (Legal Business Name): SUPERB HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/11/2007
Last Update Date: 09/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4480 GENERAL DEGAULLE DR
NEW ORLEANS LA
70131-6941
US
IV. Provider business mailing address
PO BOX 6742
NEW ORLEANS LA
70174-6742
US
V. Phone/Fax
- Phone: 504-975-1242
- Fax: 504-367-8592
- Phone: 504-975-1242
- Fax: 504-367-8592
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 372600000X |
| Taxonomy | Adult Companion |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
NIENGALA
ALPHANETTE
DUKES
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 504-975-1242