Organization
HP SUPERIOR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS K MITTLEIDER (PRESIDENT)
(770) 619-0866
Entity
Organization
Contact information
Practice address
1800 NEW YORK AVE, SUPERIOR, WI 54880-2008
(715) 394-5591
(715) 394-5098
Mailing address
925 N POINT PKWY, SUITE 440, ALPHARETTA, GA 30005-5210
(770) 619-0866
(770) 870-2892
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2578
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20192500
—
WI
Enumeration date
07/10/2006
Last updated
08/22/2020
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