Supreme Healthcare & Wellness Services LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SUPREME HEALTHCARE & WELLNESS SERVICES LLC

Practice address

12401 Middlebrook Rd Ste 190
Germantown, MD 20874-1521

Phone

(240) 476-2106

Fax

(877) 775-1766

NPI assigned

Apr 19, 2022

Last updated

Aug 29, 2022By 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

Judith Akoh-Arrey, NPNPI 1699336651

Title

Provider

Phone

(240) 432-6971

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Tax ID family

Supreme Healthcare Wellness Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Supreme Healthcare & Wellness Services LLC

  • Primary Care Clinic/Center
  • Germantown, MD
  • NPI 1184304610
  NPD tax ID

Practitioners 2

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.

• Judith Besem Akoh-Arrey, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Germantown, MD
  • NPI 1699336651

  DC, Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Habibatu Kemoh Sesay, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • North Potomac, MD
  • NPI 1043852023

  DC

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661731200000",
    "number": "1215670047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12401 MIDDLEBROOK RD STE 190",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741521",
            "telephone_number": "855-208-0890",
            "fax_number": "240-317-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 MIDDLEBROOK RD STE 190",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741521",
            "telephone_number": "240-476-2106",
            "fax_number": "877-775-1766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10810 BARNESTOWN RD",
            "address_2": "STE 202",
            "address_purpose": "LOCATION",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "20878",
            "country_code": "US",
            "telephone_number": "240-432-6971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUPREME HEALTHCARE & WELLNESS SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A",
        "authorized_official_last_name": "AKOH-ARREY",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "240-432-6971",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.supremehcws.com",
            "affiliation": "N",
            "address_1": "12401 Middlebrook Rd Ste 190",
            "city": "Germantown",
            "state": "MD",
            "country_code": "US",
            "postal_code": "208741521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Germantown, MD
• Providers in Germantown, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.