Supreme Residential Care, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SUPREME RESIDENTIAL CARE, LLC

Practice address

315 Roche Dr
Durham, NC 27703

Phone

(919) 482-8299

NPI assigned

Aug 18, 2023

Organization subpart

No

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

Authorized official

Name

John Chambers

Title

Owner

Phone

(919) 482-8299

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1245013580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 ROCHE DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27703",
            "telephone_number": "919-482-8299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 ROCHE DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27703",
            "telephone_number": "919-482-8299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME RESIDENTIAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-18",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-482-8299"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian Brooke Supranowitz
• Supreme Care, Inc.
• Supreme Family Care Home
• Supreme Family Care Home
• Supreme Mobile Testing LLC
• Amol Ashwin Sura, M.D.
• Nandana Surana, LPA
• Brandon Chase Surber, ATC
• Tara Suresh
• Courtney Lynn Surigao, MA

• Assisted Living Facility in Durham, NC
• Providers in Durham, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.