# SUPREME REHAB INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SUPREME HOME CARE AND REHAB INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477627115
- **Authorized official:** NASEEM AHMED KHAN (OWNER / ADMINISTRATOR)
- **Authorized official phone:** (248) 214-1234

## Contact information

- **Practice address:** 29930 W 12 MILE RD STE 3, FARMINGTON HILLS, MI 48334-3983
- **Practice address phone:** (248) 862-2512
- **Practice address fax:** (248) 862-2145
- **Mailing address:** 29930 W 12 MILE RD STE 3, FARMINGTON HILLS, MI 48334-3983
- **Mailing address phone:** (248) 862-2512
- **Mailing address fax:** (248) 862-2145

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 638089 | MI | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 4105160001 | MI | — |

## Other

- **Enumeration date:** 11/17/2006
- **Last updated:** 04/16/2022