Supreme Home Llc

LBN: Supreme Home Llc
Supreme Home Llc is an health care organization with primary practice located at 1735 Minerva Way , Anchorage AK 99515-1490. The organization recently has 3 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living Facility, Nursing & Custodial Care Facilities / Assisted Living, Behavioral Disturbances, Nursing & Custodial Care Facilities / Custodial Care Facility. Nursing & Custodial Care Facilities / Custodial Care Facility is the primary health care specialty. Supreme Home Llc can be contacted via phone (907) 334-6468, or through Walker Kolawole, Ajoke Olohima via phone (907) 830-6959.

Contact Information

Primary practice address
1735 Minerva Way Anchorage AK 99515-1490
Phone: (907) 334-6468
Fax: (907) 868-4670
Website:
Map and Directions
Authorized official contact:
Name: Walker Kolawole, Ajoke Olohima BA, C.N.A
Phone: (907) 830-6959

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X
Nursing & Custodial Care Facilities / Assisted Living, Behavioral Disturbances 3104A0630X
Nursing & Custodial Care Facilities / Custodial Care Facility 311Z00000X Alaska

Profile Details

NPI number 1033617881
LBN Legal business name Supreme Home Llc
DBA Doing business as
Authorized official Walker Kolawole, Ajoke Olohima BA, C.N.A
Entity Organization
Organization subpart 1 No
Enumeration date Jan 26th, 2018
Last updated Jan 26th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033617881 NPPES
Alaska MEDICAID 1030505

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