Superior Sober House

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

SUPERIOR SOBER HOUSE

Doing business as

Superior Connections RCO

Practice address

620 S Lake St
Marquette, MI 49855-5150

Phone

(248) 563-9988

NPI assigned

Feb 14, 2024

Last updated

Feb 14, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

SUPERIOR SOBER HOUSEAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ryan Todd Redmond, CHW,CPRC

Title

Executive Director

Phone

(248) 563-9988

Specialties & licenses 1

Addresses

Other names 1

• Superior Connections RCO Doing business as

Part of

Superior Sober House

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1780449306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 822",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498550822",
            "telephone_number": "248-536-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S LAKE ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498555150",
            "telephone_number": "248-563-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR SOBER HOUSE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUPERIOR SOBER HOUSE",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A",
        "authorized_official_last_name": "REDMOND",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "248-563-9988",
        "authorized_official_credential": "CHW,CPRC"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Superior Connections RCO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Superior Walk-in Center, PC (Superior Walk-In & Family Health)
• Superior Walk-in Center, PC (Superior Walk-In & Family Health)

• Community Health Worker in Marquette, MI
• Providers in Marquette, MI by specialty
• Community Health Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.