Supreme Healthcare Agency LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

SUPREME HEALTHCARE AGENCY LLC

Practice address

38335 Tamarac Blvd Apt 220
Willoughby, OH 44094-8195

Phone

(440) 521-2276

NPI assigned

May 30, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Tina M Campbell-Rasberry, RN

Title

Ceo

Phone

(440) 521-2276

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527638400000",
    "number": "1639661317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38335 TAMARAC BLVD APT 220",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440948195",
            "telephone_number": "440-521-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38335 TAMARAC BLVD APT 220",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440948195",
            "telephone_number": "440-521-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME HEALTHCARE AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-30",
        "last_updated": "2018-05-30",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL-RASBERRY",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "440-521-2276",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shirley Stubbs, QMHS
• Mary E. Suhayda
• Amy Sullivan
• Richard C Sumrada
• Joshua J Sunshine, M.D.
• Jennifer Sustar, LPCC
• Ashley Nicole Sutkowski, APRN, CNP
• Richard Thomas Sutton, RN
• Pamela Suvanna
• Kimberly Ann Svec, FNP-C

• Developmentally Disabled Services Day Training Agency in Willoughby, OH
• Providers in Willoughby, OH by specialty
• Developmentally Disabled Services Day Training Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; 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.