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SUPREME CARE SERVICESLLC
NPI 1104792183
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Hyattsville, MD

Active since October 15, 2025
4738 68TH AVE, HYATTSVILLE, MD 20784(301) 814-1509(301) 814-1509 Get Directions Write a Review

NPPES record last updated: December 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Supreme Care Servicesllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUPREME CARE SERVICESLLC (NPI 1104792183) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Hyattsville, Maryland and active in the NPI registry since October 2025. The organization lists Korpo Kollie Johnson, President, as its authorized official.

NPPES Registry Identity

NPI1104792183
Entity TypeOrganization
Primary Taxonomy320600000X
Legal Business NameSUPREME CARE SERVICESLLC
Location Address4738 68TH AVEHyattsville, MD 20784-1400
Mailing Address4738 68th AveHyattsville, MD 20784-1400 · (301) 814-1509 · Fax (301) 814-1509
Phone(301) 814-1509
Fax(301) 814-1509
Organization SubpartNo
Authorized OfficialKorpo Kollie JohnsonPresident · (301) 814-1509
Enumeration DateOctober 15, 2025
Last NPPES UpdateDecember 8, 2025
NPPES CertifiedDecember 8, 2025
✔ NPI 1104792183 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320600000X
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
4738 68TH AVE, Hyattsville, MD 20784
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUPREME CARE SERVICESLLC
Home Health
4738 68TH AVE
HYATTSVILLE, MD 20784
Prince George's County (301) 814-1509

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Supreme Care Servicesllc's NPI number?

The NPI number for Supreme Care Servicesllc is 1104792183. It was assigned to this organization in the NPPES registry on October 15, 2025.

Where is Supreme Care Servicesllc located?

Supreme Care Servicesllc is located at 4738 68th Ave, Hyattsville, MD 20784. The listed phone number is (301) 814-1509.

What is Supreme Care Servicesllc's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

When was this NPI record last updated?

The NPPES record for Supreme Care Servicesllc was last updated on December 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.