MEDICARE: SUPERIOR ELEGANCE 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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1538026901
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPERIOR ELEGANCE CARE LLC

Provider Business Mailing Address
First Line	:	2271 LAKE CREST DR APT 1
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-3395
Country	:	US
Telephone Number	:	317-526-8212
Fax Number	:

Provider Business Practice Location Address
First Line	:	2271 LAKE CREST DR APT 1
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-3395
Country	:	US
Telephone Number	:	317-526-8212
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TIERRA HART
Credential	:
Telephone Number	:	317-526-8212

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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