Supreme Wellness Recovery South LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SUPREME WELLNESS RECOVERY SOUTH LLC

Practice address

638 Newtown Yardley Rd Ste 1F
Newtown, PA 18940-1740

Phone

(215) 874-3636

NPI assigned

Nov 20, 2018

Last updated

Mar 14, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Huma Mahmood, DO

Title

Medical Director

Phone

(215) 874-3636

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678752000000",
    "number": "1164991105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 NEWTOWN YARDLEY RD STE 1F",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401740",
            "telephone_number": "215-768-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 NEWTOWN YARDLEY RD STE 1F",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401740",
            "telephone_number": "215-874-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME WELLNESS RECOVERY SOUTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-20",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A",
        "authorized_official_last_name": "MAHMOOD",
        "authorized_official_first_name": "HUMA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "215-874-3636",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Newtown, PA
• Providers in Newtown, PA by specialty
• Community/Behavioral Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.