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General NPI Number Information
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NPI Number | 1225135437
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Entity Type | Organization
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Legal Business Name | SUPREME HOME HEALTH SERVICES INC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1110 JACKSON ST
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City | MONROE
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State | LA
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Zip | 71202-2024
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Country | US
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Telephone | 318-323-5489
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Fax | 318-323-8602
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Provider Business Mailing Address
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Address Line | 1110 JACKSON ST PO BOX 3145
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City | MONROE
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State | LA
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Zip | 71202-2024
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Country | US
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Telephone | 318-323-5489
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Fax | 318-323-8602
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Authorized Official
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Title or Position | C.E.O.
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Name | MRS. EMILY B WINSTON
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Credential | R.N.
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Telephone | 318-325-8863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 121
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License Number State | LA
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