SUPREME INDEPENDENCE ROOM AND BOARD
NPI 1972267870
Lodging in Detroit, MI

Q: What is Supreme Independence Room And Board's NPI number?

The NPI number for Supreme Independence Room And Board is 1972267870. It was assigned to this organization in the NPPES registry on October 26, 2021.

Q: What is Supreme Independence Room And Board's specialty?

The primary specialty registered for this NPI is Lodging with taxonomy code 177F00000X.

Active since October 26, 2021

12844 BROADSTREET AVE, DETROIT, MI 48238(313) 459-9538 Get Directions Write a Review

NPPES record last updated: October 26, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Supreme Independence Room And Board NPPES

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

SUPREME INDEPENDENCE ROOM AND BOARD (NPI 1972267870) is a healthcare organization registered as a lodging in Detroit, Michigan and active in the NPI registry since October 2021. The organization lists James Blake, Owner, as its authorized official.

NPPES Registry Identity

NPI1972267870

Entity TypeOrganization

Primary Taxonomy177F00000X

Legal Business NameSUPREME INDEPENDENCE ROOM AND BOARD

Location Address12844 BROADSTREET AVEDetroit, MI 48238-3250

Mailing Address36306 Dominion CirSterling Heights, MI 48310-7458 · (810) 660-1892

Phone(313) 459-9538

Organization SubpartNo

Authorized OfficialJames BlakeOwner · (810) 660-1892

Enumeration DateOctober 26, 2021

NPPES CertifiedOctober 26, 2021

✔ NPI 1972267870 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLodgingOther Service Providers

Taxonomy Code177F00000X

Definition

A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home.

12844 BROADSTREET AVE, Detroit, MI 48238

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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 Independence Room And Board's NPI number?

The NPI number for Supreme Independence Room And Board is 1972267870. It was assigned to this organization in the NPPES registry on October 26, 2021.

Where is Supreme Independence Room And Board located?

Supreme Independence Room And Board is located at 12844 Broadstreet Ave, Detroit, MI 48238. The listed phone number is (313) 459-9538.

What is Supreme Independence Room And Board's specialty?

The primary specialty registered for this NPI is Lodging with taxonomy code 177F00000X.

When was this NPI record last updated?

The NPPES record for Supreme Independence Room And Board was last updated on October 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.