Supreme Nursing Care And Supported Living LLC
Home Health in Cherry Hill, NJ. Organization (NPI-2).
NPI number1982175154
StatusActive
Last updated in NPPESFeb 5, 2025
Details
- NPI
- 1982175154
- Entity type
- Organization (NPI-2)
- Legal business name
- Supreme Nursing Care And Supported Living LLC
- Organization subpart
- No
- Enumeration date
- Dec 16, 2018
- Certification date
- Feb 5, 2025
- Last updated
- Feb 5, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251E00000X | Home Health | – | – | Yes |
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | |
| 343900000X | Non-emergency Medical Transport (VAN) | – | – |
Practice location
1401 Marlton Pike E Ste 22aCherry Hill, NJ 08034-2207
Phone 614-929-1931
Mailing address
1101 W Hamilton St Ste 141Allentown, PA 18101-1043
Phone 614-929-1931
Other practice locations
1101 W Hamilton St Ste 141
Allentown, PA 18101-1043
Allentown, PA 18101-1043
Phone 614-929-1931
Authorized official
Mohamed Baba Fofanah
Ceo
6149291931
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All 43 Home Health Agency providers in Cherry Hill · All 5,514 providers in Cherry Hill
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