Supreme Care DKS, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SUPREME CARE DKS, LLC

Practice address

3903 Genacre LN
Richmond, VA 23222-1731

Phone

(804) 687-9427

Fax

(804) 486-6620

NPI assigned

Dec 31, 2024

Organization subpart

No

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

Authorized official

Name

Katrina S SamuelsNPI 1427805241

Title

Owner

Phone

(804) 687-9427

Specialties & licenses 1

Addresses

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Supreme S&S Care DKS, LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Richmond, VA
  • NPI 1235068933
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Katrina Sabrina Samuels

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Richmond, VA
  • NPI 1427805241

  Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD Authorized official

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

{
    "created_epoch": "1735603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735603200000",
    "number": "1073322459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 GENACRE LN",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232221731",
            "telephone_number": "804-687-9427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 GENACRE LN",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232221731",
            "telephone_number": "804-687-9427",
            "fax_number": "804-486-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME CARE DKS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-31",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A",
        "authorized_official_last_name": "SAMUELS",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-687-9427"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Support Coordinators LTD
• Supportive Intervention Services, LLC
• Supportive Residential LLC
• Supportone Inc (Community-Based Services, Inc.)
• Supports for Seniors LLC (Community Alternatives Consortium)
• Supreme S&S Care DKS, LLC
• Gopika Suraj, MD
• Annika Surya Surapaneni, MD
• Suresh Gharse, MD
• Bangalore Suresh, MD

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Richmond, VA
• Providers in Richmond, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.