Provider Demographics
NPI:1174781645
Name:SUPERIOR SENIOR CARE
Entity type:Organization
Organization Name:SUPERIOR SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:QUINCY
Authorized Official - Middle Name:
Authorized Official - Last Name:HURST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-321-1743
Mailing Address - Street 1:620 OUACHITA AVE
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-3920
Mailing Address - Country:US
Mailing Address - Phone:501-321-1743
Mailing Address - Fax:501-623-7853
Practice Address - Street 1:715 W GRAND AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-3530
Practice Address - Country:US
Practice Address - Phone:501-321-1743
Practice Address - Fax:501-623-7853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-30
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 253Z00000X
AR141026765251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR123989757Medicaid
AR164215797Medicaid
AR126107752Medicaid
AR164300796Medicaid
AR164592798Medicaid
AR126106750Medicaid
AR141025732Medicaid
AR141026765Medicaid