National Provider Identifier Database

SUPREME HEALTHCARE SERVICES LLC
Custodial Care Facility

A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel.


Contact Information

SUPREME HEALTHCARE SERVICES, LLC
4611 CLAY ST NE
WASHINGTON, DC20019-4663
Phone: 240-357-8763
Fax: 240-863-3313
Website:
Specialty Taxonomy Code
* Custodial Care Facility 311Z00000X

* Indicates primary specialty

NPI Profile & details for SUPREME HEALTHCARE SERVICES, LLC

NPI Number 1871864124
Legal business name
LBN
SUPREME HEALTHCARE SERVICES, LLC
Authorized official GANIYAT EFUNTOYE - (PRESIDENT/CEO)
Entity Organization
Organization subpart No
Enumeration date 01/18/2012
Last updated 05/11/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • DC Medicaid: 057293200

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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