MEDICARE: SUPERIOR IN HOME CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1437824240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPERIOR IN HOME CARE, LLC

Provider Business Mailing Address
First Line	:	7 CHURCH LN STE 8
Second Line	:
City	:	PIKESVILLE
State	:	MD
Zip	:	21208-3717
Country	:	US
Telephone Number	:	410-541-0182
Fax Number	:	410-504-5554

Provider Business Practice Location Address
First Line	:	7 CHURCH LN STE 8
Second Line	:
City	:	PIKESVILLE
State	:	MD
Zip	:	21208-3717
Country	:	US
Telephone Number	:	410-541-0182
Fax Number	:	410-504-5554

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. KEYSHA RACHEL HARRISON
Credential	:
Telephone Number	:	410-541-0182

Provider Enumeration Date	:	08/13/2021
Last Update Date	:	08/13/2021

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