| Organization Name: | SUPREME HOME CARE LLC |
| NPI Number: | 1760626949 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GREGORY RILEY (ASSISTANT ADMINISTRATOR) |
| Mailing Address: | 2010 Woodmere Blvd Suite B Harvey |
| State: | LA US |
| Postal Code: | 700582286 |
| Phone Number: | 5043409313 |
| Fax Number: | 5043409314 |
| NPI Enumeration Date: | 05/01/2009 |
| NPI Last Update Date: | 05/05/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | 15107 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |