# SUPREME LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003182155
- **Authorized official:** AGNES MASAWE (PRESIDENT)
- **Authorized official phone:** (202) 255-2574

## Contact information

- **Practice address:** 2849 GEORGIA AVE NW, SUITE 2, WASHINGTON, DC 20001-5600
- **Practice address phone:** (202) 525-2175
- **Practice address fax:** (202) 525-2177
- **Mailing address:** 2849 GEORGIA AVE NW, SUITE 2, WASHINGTON, DC 20001-5600
- **Mailing address phone:** (202) 525-2175
- **Mailing address fax:** (202) 525-2177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 03/22/2012
- **Last updated:** 03/22/2012