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General NPI Number Information
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NPI Number | 1881806057
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Entity Type | Organization
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Legal Business Name | SUPER HEALTH CARE, INC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6795 E TENNESSEE AVENUE SUITE 225
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City | DENVER
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State | CO
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Zip | 80224
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Country | US
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Telephone | 303-991-1009
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Fax | 303-388-3152
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Provider Business Mailing Address
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Address Line | 6795 E TENNESSEE AVENUE SUITE 225
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City | DENVER
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State | CO
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Zip | 80224
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Country | US
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Telephone | 303-991-1009
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Fax | 303-388-3152
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MARINA GRENKEL
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Credential |
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Telephone | 303-991-1009
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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 | 72006757
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License Number State | CO
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