Organization
SUPERIOR SENIOR HOME CARE INC
Active
Other names
Superior Senior Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PABLO SANDOVAL MARTINEZ (CEO)
(805) 588-0213
Entity
Organization
Contact information
Practice address
320 E WALNUT AVE, LOMPOC, CA 93436-6835
(805) 737-4357
Mailing address
320 E WALNUT AVE, LOMPOC, CA 93436-6835
(805) 737-4357
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0790621
DRIVERS LICENSE
CA
Enumeration date
02/17/2021
Last updated
02/17/2021
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