Organization
SUPERIOR HOME HEALTH CARE 10603, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HOWARD GIST JONES JR. (PRESIDENT)
(952) 898-5400
Entity
Organization
Contact information
Practice address
10603 165TH ST W, LAKEVILLE, MN 55044-3514
(952) 898-5400
(952) 898-5454
Mailing address
10603 165TH ST W, LAKEVILLE, MN 55044-3514
(952) 898-5400
(952) 898-5454
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
364481
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H28996
MINNESOTA DEPARTMENT OF HEALTH
MN
Enumeration date
10/08/2013
Last updated
10/08/2013
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