Organization
A SUPREME NURSING AND HOMECARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA LORRAINE BROWN-JOSEPH (DIRECTOR)
(678) 224-5973
Entity
Organization
Contact information
Practice address
3400 CHAPEL HILL RD, 104, DOUGLASVILLE, GA 30135-1739
(678) 224-5971
(888) 524-7084
Mailing address
3400 CHAPEL HILL RD, 104, DOUGLASVILLE, GA 30135-1739
(678) 224-5971
(888) 524-7084
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
048-R-0730
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03113601A
—
GA
Enumeration date
01/10/2012
Last updated
05/06/2015
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