MEDICARE: A1 SUPREME ESSENTIAL CARE SOLUTION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1962373712
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A1 SUPREME ESSENTIAL CARE SOLUTION LLC

Provider Business Mailing Address
First Line	:	4256 E 164TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-2410
Country	:	US
Telephone Number	:	216-370-8990
Fax Number	:

Provider Business Practice Location Address
First Line	:	4256 E 164TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-2410
Country	:	US
Telephone Number	:	216-370-8990
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	MS. KIMBERLY HILL
Credential	:
Telephone Number	:	216-370-8990

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	09/15/2025

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