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Contact Information

SUPREME LIVING LLC
6604 MARTIN WAY E
OLYMPIA, WA98516
 Phone: 360-362-7002
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
Indicates primary specialty

NPI Profile & details for SUPREME LIVING LLC

NPI Number 1154085181
LBN Legal business name SUPREME LIVING LLC
Authorized official ANGELA RINALDO - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 10/26/2021
Last updated 05/19/2022 - About 4 years ago
Identifiers
WA Medicaid 2171006
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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