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SUPREME TEAM LLC NPI 1912261231


NPI Information

NPI: 1912261231
Provider Name: SUPREME TEAM LLC

Doing Business As: LONGEVITY PERSONAL CARE HOME

Classification: Custodial Care Facility - 311Z00000X
Entity Type: Organization
Address:
1520 12TH ST
AUGUSTA, GA
ZIP 30901
Phone: (706) 364-4710
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SUPREME TEAM LLC is a custodial care facility in Augusta, GA. The provider is a facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. SUPREME TEAM LLC NPI is 1912261231. The provider is registered as an organization entity type.
The provider Is Doing Business As Longevity Personal Care Home.

The provider's business location address is:

1520 12TH ST
AUGUSTA, GA
ZIP 30901-676
Phone: (706) 364-4710

The provider's authorized official is Caletha Taylor .
The authorized official title is Manager and has the following contact phone number (706) 951-7514.

The enumeration date for this NPI number is 7/2/2012 and was last updated on 7/2/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311Z00000XCustodial Care FacilityGEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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