Supreme Independence Room And Board

LBN: Supreme Independence Room And Board
Supreme Independence Room And Board is an health care organization with primary practice located at 12844 Broadstreet Ave , Detroit MI 48238-3250. The organization recently has only one registered license in Other Service Providers / Lodging, which is considered as the primary health care specialty. Supreme Independence Room And Board can be contacted via phone (313) 459-9538, or through Blake, James via phone (810) 660-1892.

Contact Information

Primary practice address
12844 Broadstreet Ave Detroit MI 48238-3250
Phone: (313) 459-9538
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Blake, James
Phone: (810) 660-1892

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Lodging 177F00000X

Profile Details

NPI number 1972267870
LBN Legal business name Supreme Independence Room And Board
DBA Doing business as
Authorized official Blake, James
Entity Organization
Organization subpart 1 No
Enumeration date Oct 26th, 2021
Last updated Oct 26th, 2021 - about 5 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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