| Organization Name: | SUPREME HEALTHCARE SERVICES, LLC |
| NPI Number: | 1871864124 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID OLALEKAN EFUNTOYE (PRESIDENT/CEO) |
| Mailing Address: | 6475 New Hampshire Ave Suite 315 Hyattsville |
| State: | MD US |
| Postal Code: | 207833282 |
| Phone Number: | 2403153101 |
| Fax Number: | 3013287469 |
| NPI Enumeration Date: | 01/18/2012 |
| NPI Last Update Date: | 01/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 311Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Custodial Care Facility |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. |