Healthcare Provider Details

I. General information

NPI: 1851333165
Provider Name (Legal Business Name): SUPERIOR HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 STATE ROUTE 36
ATLANTIC HIGHLANDS NJ
07716-2533
US

IV. Provider business mailing address

62 MONMOUTH PKWY
MONMOUTH BEACH NJ
07750-1130
US

V. Phone/Fax

Practice location:
  • Phone: 732-693-1779
  • Fax:
Mailing address:
  • Phone: 732-693-1779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number07221
License Number StateNJ

VIII. Authorized Official

Name: MRS. LISA A. GERSTMYER
Title or Position: OWNER
Credential: P.T.
Phone: 732-693-1779