SUPREME INDEPENDENCE ROOM AND BOARD is a lodging in Detroit, MI. The provider is a public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home. SUPREME INDEPENDENCE ROOM AND BOARD NPI is 1972267870. The provider is registered as an organization entity type.
The provider's business location address is:
12844 BROADSTREET AVE DETROIT, MI ZIP 48238-250 Phone: (313) 459-9538
The provider's authorized official is James Blake . The authorized official title is Owner and has the following contact phone number (810) 660-1892.
The enumeration date for this NPI number is 10/26/2021 and was last updated on 10/26/2021.
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:
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: 11/21/2025
NPI Synchronization or Removal
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.
