# SUPERIOR ASSISTED LIVING, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639771165
- **Authorized official:** MS. LORRIE REGINA DAVIS (PRESIDENT)
- **Authorized official phone:** (443) 468-2101

## Contact information

- **Practice address:** 4134 W FOREST PARK AVE, GWYNN OAK, MD 21207-7407
- **Practice address phone:** (443) 800-2530
- **Practice address fax:** (443) 378-5700
- **Mailing address:** 8201 HARFORD RD UNIT 8417, PARKVILLE, MD 21234-7545
- **Mailing address phone:** (410) 800-2530
- **Mailing address fax:** (443) 378-5700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 3104A0625X | Assisted Living Facility (Mental Illness) | — | NULL | — |

## Other

- **Enumeration date:** 11/10/2020
- **Last updated:** 11/10/2020