# SUPREME HOME CARE

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

## Provider details

- **NPI number:** 1003588724
- **Authorized official:** NICKISHA SIMS (ADMINISTRATOR)
- **Authorized official phone:** (414) 635-7380

## Contact information

- **Practice address:** 7620 W CENTER ST STE 201, MILWAUKEE, WI 53222-5083
- **Practice address phone:** (414) 935-2799
- **Practice address fax:** (414) 935-2603
- **Mailing address:** 7620 W CENTER ST STE 201, MILWAUKEE, WI 53222-5083
- **Mailing address phone:** (414) 935-2799
- **Mailing address fax:** (414) 935-2603

## Taxonomy

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

## Other

- **Enumeration date:** 09/30/2021
- **Last updated:** 11/19/2024