Supreme Care LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SUPREME CARE LLC

Practice address

510 Cumberland Ave Unit 302
Portland, ME 04101-7208

Phone

(515) 771-6546

NPI assigned

Jul 4, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Mukiza Gloire ShamaragweNPI 1942190715

Title

Ceo

Phone

(515) 771-6546

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mukiza Gloire Shamaragwe

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Portland, ME
  • NPI 1942190715

  Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD Authorized official

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

{
    "created_epoch": "1751587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751587200000",
    "number": "1790675411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 CUMBERLAND AVE UNIT 302",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041017208",
            "telephone_number": "515-771-6546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 CUMBERLAND AVE UNIT 302",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041017208",
            "telephone_number": "515-771-6546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-04",
        "last_updated": "2025-07-04",
        "certification_date": "2025-07-04",
        "status": "A",
        "authorized_official_last_name": "SHAMARAGWE",
        "authorized_official_first_name": "MUKIZA",
        "authorized_official_middle_name": "GLOIRE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-771-6546",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Laurie A Sutherland, M.D.
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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Portland, ME
• Providers in Portland, ME by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2025; 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.