Organization
SUPERIOR NEW LIFE SERVICES INC
Active
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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