Organization
SUPREME CARE SERVICESLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KORPO KOLLIE JOHNSON NURSE (PRESIDENT)
(301) 814-1509
Entity
Organization
Contact information
Practice address
4738 68TH AVE, HYATTSVILLE, MD 20784-1400
(301) 814-1509
(301) 814-1509
Mailing address
4738 68TH AVE, HYATTSVILLE, MD 20784-1400
(301) 814-1509
(301) 814-1509
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/15/2025
Last updated
12/08/2025
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