Organization
SUPERIOR HOME CARE SERIVCES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KISHA WILSON (OWNER)
(317) 208-0638
Entity
Organization
Contact information
Practice address
2252 GRADISON DR, INDIANAPOLIS, IN 46214-2055
(317) 208-0628
Mailing address
2345 S LYNHURST DR STE 110, INDIANAPOLIS, IN 46241-5100
(317) 208-0628
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300074030
—
IN
Enumeration date
02/15/2023
Last updated
04/21/2024
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