# A&O SUPREME CARE

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

## Provider details

- **NPI number:** 1104691302
- **Authorized official:** JUDITH NGIEH (DIRECTOR)
- **Authorized official phone:** (240) 821-2078

## Contact information

- **Practice address:** 4200 EVERGREEN LN STE 332, ANNANDALE, VA 22003-3252
- **Practice address phone:** (240) 821-2078
- **Mailing address:** 4807 TYLERS HOPE DR, BOWIE, MD 20720-6303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 11/17/2023
- **Last updated:** 11/17/2023