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Organization

SUPERIOR NEW LIFE SERVICES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MYLENA RUIZ MEDINA (ADMINISTRATOR)
(813) 442-8480
Entity
Organization

Contact information

Practice address
8009 N CAMERON AVE, TAMPA, FL 33614-2592
(813) 442-8480
(813) 434-2483
Mailing address
8009 N CAMERON AVE, TAMPA, FL 33614-2592
(813) 442-8480
(813) 434-2483

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
251E00000X
Home Health Agency
261QD1600X
Developmental Disabilities Clinic/Center
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Enumeration date
03/21/2024
Last updated
03/21/2024
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