Organization
SUPREME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AGNES MASAWE (PRESIDENT)
(202) 255-2574
Entity
Organization
Contact information
Practice address
2849 GEORGIA AVE NW, SUITE 2, WASHINGTON, DC 20001-5600
(202) 525-2175
(202) 525-2177
Mailing address
2849 GEORGIA AVE NW, SUITE 2, WASHINGTON, DC 20001-5600
(202) 525-2175
(202) 525-2177
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
03/22/2012
Last updated
03/22/2012
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