| NPI | 1730759168 |
|---|---|
| Doing Business As | SUPREME HABILITATIVE SERVICES |
| Entity Type | Organization |
| Authorized Contact | RACKAYE J SIMMONS CEO 866-751-8330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 253Z00000X In Home Supportive Care | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2021-11-27 |