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 |