Supreme Care Servicesllc
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Hyattsville, MD. Organization (NPI-2).
Details
- NPI
- 1104792183
- Entity type
- Organization (NPI-2)
- Legal business name
- Supreme Care Servicesllc
- Organization subpart
- No
- Enumeration date
- Oct 15, 2025
- Certification date
- Dec 8, 2025
- Last updated
- Dec 8, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | Yes |
Practice location
4738 68th AveHyattsville, MD 20784-1400
Phone 301-814-1509 · Fax 301-814-1509
Mailing address
4738 68th AveHyattsville, MD 20784-1400
Phone 301-814-1509 · Fax 301-814-1509
Authorized official
Korpo Kollie Johnson
President
3018141509
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