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General NPI Number Information
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NPI Number | 1740862903
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Entity Type | Organization
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Legal Business Name | SUPERIOR HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 04/26/2021
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 6725 DALY RD UNIT 251661
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48325-3268
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Country | US
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Telephone | 313-395-4090
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 251661
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48325-1661
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Country | US
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Telephone | 313-395-4090
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHADESHA JOHNSON
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Credential |
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Telephone | 313-286-7409
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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