Supreme Home Care Provider, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SUPREME HOME CARE PROVIDER, LLC

Practice address

1710 Douglas Dr N Ste 277
Golden Valley, MN 55422-4344

Phone

(763) 710-9907

Fax

(763) 710-9976

NPI assigned

Jan 4, 2012

Organization subpart

No

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

Authorized official

Name

Hassan Osman Yusuf

Title

Owner/Manager

Phone

(763) 710-9907

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432252800000",
    "number": "1427328780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 DOUGLAS DR N STE 277",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224344",
            "telephone_number": "763-710-9907",
            "fax_number": "763-710-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 DOUGLAS DR N STE 277",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224344",
            "telephone_number": "763-710-9907",
            "fax_number": "763-710-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME HOME CARE PROVIDER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-04",
        "last_updated": "2015-05-22",
        "status": "A",
        "authorized_official_last_name": "YUSUF",
        "authorized_official_first_name": "HASSAN",
        "authorized_official_middle_name": "OSMAN",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "763-710-9907"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Edward Stucky, MA/LP
• Jessica Lauren Stulc, MD
• Sienneh Subah
• Summit Home Health Care, Inc.
• Superior Hospice Inc.
• Christa Ruth Surerus, LPCC
• Lisa Sutton, PHARMD
• Amy Svenningsen
• Erica Lynn Swanson, MOT, OTR/L
• Rachel Swanson, MSN, APRN, AGNP-C

• Home Health Agency in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; 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.