SUPREME HEALTHCARE SERVICES, LLC
NPI 1871864124
Custodial Care Facility in Washington, DC

Q: What is Supreme Healthcare Services, LLC's NPI number?

The NPI number for Supreme Healthcare Services, LLC is 1871864124. It was assigned to this organization in the NPPES registry on January 18, 2012.

Q: What is Supreme Healthcare Services, LLC's specialty?

The primary specialty registered for this NPI is Custodial Care Facility with taxonomy code 311Z00000X.

Active since January 18, 2012

4611 CLAY ST NE, WASHINGTON, DC 20019(240) 357-8763(240) 863-3313 Get Directions Write a Review

NPPES record last updated: May 11, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Supreme Healthcare Services, Llc NPPES

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

SUPREME HEALTHCARE SERVICES, LLC (NPI 1871864124) is a healthcare organization registered as a custodial care facility in Washington, District Of Columbia and active in the NPI registry since January 2012. The organization lists Ganiyat Funmi Efuntoye, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1871864124

Entity TypeOrganization

Primary Taxonomy311Z00000X

Legal Business NameSUPREME HEALTHCARE SERVICES, LLC

Location Address4611 CLAY ST NEWashington, DC 20019-4663

Mailing Address6475 New Hampshire Ave, Suite 315Hyattsville, MD 20783-3282 · (240) 357-8763 · Fax (240) 863-3313

Phone(240) 357-8763

Fax(240) 863-3313

Organization SubpartNo

Authorized OfficialGaniyat Funmi EfuntoyePresident/ceo · (240) 357-8763

Enumeration DateJanuary 18, 2012

Last NPPES UpdateMay 11, 2017

✔ NPI 1871864124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care FacilityNursing & Custodial Care Facilities

Taxonomy Code311Z00000X

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.

4611 CLAY ST NE, Washington, DC 20019

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Other Identifiers 1

Medicaid057293200DC

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 Healthcare Services, LLC's NPI number?

The NPI number for Supreme Healthcare Services, LLC is 1871864124. It was assigned to this organization in the NPPES registry on January 18, 2012.

Where is Supreme Healthcare Services, LLC located?

Supreme Healthcare Services, LLC is located at 4611 Clay St NE, Washington, DC 20019. The listed phone number is (240) 357-8763.

What is Supreme Healthcare Services, LLC's specialty?

The primary specialty registered for this NPI is Custodial Care Facility with taxonomy code 311Z00000X.

When was this NPI record last updated?

The NPPES record for Supreme Healthcare Services, LLC was last updated on May 11, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.