| NPI | 1851819585 |
|---|---|
| Former Legal Business Name | SUPERIOR PRO-CARE HOME PROVIDER |
| Doing Business As | SUPERIOR PRO CARE HOME PROVIDER |
| Entity Type | Organization |
| Authorized Contact | PATRICIA T CLAYTON Provider 769-447-5458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2022-07-21 |