SUPREME FAMILY CARE HOME (NPI# 1639575723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639575723 |
| Entity Type | Organization |
| Organization Name | SUPREME FAMILY CARE HOME |
| Practice Address |
1120 Benning St Durham NC 27703-1504 |
| Practice Telephone | 9199733724 |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2014-11-17 |
| Authorized Official Name | JULIUS AJAYI (ADMINISTRATOR) |
| Authorized Official Telephone | 9192252056 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
FCL-032-137 | NC | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285024539 | Supreme Family Care Home | Custodial Care Facility | 1120 Benning St, Durham, NC 27703-1504 | 2015-01-26 |
| Street Address |
1120 BENNING ST |
| City | DURHAM |
| State | NC |
| Zip Code | 27703-1504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285024539 | Supreme Family Care Home | Custodial Care Facility | 1120 Benning St, Durham, NC 27703-1504 | 2015-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285235218 | Joseph Omalemigbo Abgateyiniro | Durable Medical Equipment & Medical Supplies | 1810 Shiva Court, Durham, NC 27703 | 2020-11-05 |
| 1326654278 | Step By Step In Home Care LLC | Home Health | Imperial Business Park, 4819 Emperor Blvd Suite 400, Durham, NC 27703 | 2020-09-16 |
| 1023598463 | Impact Therapy Services | Speech-Language Pathologist | 6 Winnabow Court, Durham, NC 27703 | 2018-08-15 |
| 1326536327 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 1100 N Miami Blvd Ste 500a, Durham, NC 27703 | 2018-04-25 |
| 1033621719 | Duke University | Preventive Medicine | 4825 Creekstone Drive, Suite 105, Durham, NC 27703 | 2017-11-02 |
| 1023535564 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3725 Wake Forest Hwy, Durham, NC 27703 | 2017-08-25 |
| 1487194171 | Shivani L. Chudasama | Social Worker | 5475 Lumley Rd Ste 103, Durham, NC 27703 | 2017-03-01 |
| 1356886030 | Rgh Enterprises, Inc. | Durable Medical Equipment & Medical Supplies | 4234 Surles Court, Suite 100, Durham, NC 27703 | 2017-01-04 |
| 1780032821 | Victory Speech Therapy Services, Pllc | Speech-Language Pathologist | 1533 Ellis Rd., Apt J208, Durham, NC 27703 | 2016-05-31 |
| 1124422373 | Helene Azimbi Fonebi | Pharmacist | 8 Gandhi Dr, Durham, NC 27703 | 2014-10-17 |
| Find all providers in zip 27703 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356975767 | Cornerstone Community Service | Custodial Care Facility | 2220 Southgate St, Durham, NC 27703-2102 | 2020-02-24 |
| 1922570001 | Idella Wright Homes,llc | Custodial Care Facility | 822 Midway Ave, Durham, NC 27703-5128 | 2018-12-29 |
| 1891201042 | Little Family Care Home, LLC | Custodial Care Facility | 1012 Davinci Street, Durham, NC 27704 | 2017-12-26 |
| 1487190401 | Pivotal Care Group Inc | Custodial Care Facility | 2905 Guess Rd, Suite 5, Durham, NC 27705-2677 | 2017-01-14 |
| 1831641604 | Pp&v Health Care Solutions LLC | Custodial Care Facility | 4901 Paces Ferry Dr, Durham, NC 27712-4103 | 2016-10-27 |
| 1578915849 | Tender Mercies II | Custodial Care Facility | 1005 Horton Rd, Durham, NC 27704-1609 | 2016-07-11 |
| 1245628197 | Cjm Holdings LLC | Custodial Care Facility | 4111 Kismet Dr, Durham, NC 27705-2838 | 2014-12-30 |
| 1346645868 | Autumn's Way Care Home | Custodial Care Facility | 4811 Bay Point Dr, Durham, NC 27713-9413 | 2014-10-27 |
| 1245651843 | M&l Family Care | Custodial Care Facility | 2124 Strebor Street, Durham, NC 27705-2756 | 2013-12-27 |
| 1942544499 | Tonia Catrice Crawley | Custodial Care Facility | 1607 Amberly Dr, Durham, NC 27704-5109 | 2012-11-23 |
| Find all providers in DURHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.