Supreme Healthcare Services, LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

Legal business name

SUPREME HEALTHCARE SERVICES, LLC

Practice address

4611 Clay St NE
Washington, DC 20019-4663

Phone

(240) 357-8763

Fax

(240) 863-3313

NPI assigned

Jan 18, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Ganiyat Funmi Efuntoye

Title

President/Ceo

Phone

(240) 357-8763

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1871864124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6475 NEW HAMPSHIRE AVE",
            "address_2": "SUITE 315",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207833282",
            "telephone_number": "240-357-8763",
            "fax_number": "240-863-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 CLAY ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200194663",
            "telephone_number": "240-357-8763",
            "fax_number": "240-863-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "EFUNTOYE",
        "authorized_official_first_name": "GANIYAT",
        "authorized_official_middle_name": "FUNMI",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "240-357-8763",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057293200",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Superior Care Services
• Beatriz Armetania Supo
• Support System Health Services LLC
• Supreme Care Solution LLC
• Supreme Health Services, Inc.
• Supreme Homemaker Services Inc
• Supreme LLC
• Supreme Staffing&Diet Consultants
• Francis George Suprenant, DDS
• Preethi Sural, MD

• Custodial Care Facility in Washington, DC
• Providers in Washington, DC by specialty
• Custodial Care Facility in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.