OrganizationActive
Supreme Care Servicesllc
NPI 1104792183 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Hyattsville, MD
Provider details
- NPI number
- 1104792183
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Korpo Johnson, President(301) 814-1509
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4738 68th Ave
Hyattsville, MD 20784-1400
Phone: (301) 814-1509
Fax: (301) 814-1509
Street-level locationGet directions
Mailing address
4738 68th Ave
Hyattsville, MD 20784-1400
Registry dates
- Enumerated
- 2025-10-15
- Last updated
- 2025-12-08
- Certified
- 2025-12-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.