OrganizationActive
Supreme Independence Room and Board
NPI 1972267870 · Lodging Provider · Detroit, MI
Supreme Independence Room and Board is a Lodging Provider organization in Detroit, MI (NPI 1972267870).
Provider details
- NPI number
- 1972267870
- Entity type
- Organization
- Primary specialty
- Lodging ProviderOther Service Providers
- Organization subpart
- No
- Authorized official
- James Blake, Owner(810) 660-1892
Specialties & taxonomies
Other Service Providers
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES 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
12844 Broadstreet Ave
Detroit, MI 48238-3250
Phone: (313) 459-9538
Street-level locationGet directions
Mailing address
36306 Dominion Cir
Sterling Heights, MI 48310-7458
Registry dates
- Enumerated
- 2021-10-26
- Last updated
- 2021-10-26
- Certified
- 2021-10-26
Frequently asked questions
- What is Supreme Independence Room and Board's NPI number?
- Supreme Independence Room and Board's National Provider Identifier (NPI) is 1972267870, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Supreme Independence Room and Board?
- Supreme Independence Room and Board is classified in the NPPES registry as Lodging Provider (Other Service Providers).
- Where is Supreme Independence Room and Board located?
- Supreme Independence Room and Board's practice location on file with NPPES is 12844 Broadstreet Ave, Detroit, MI 48238-3250.
- What is Supreme Independence Room and Board's phone number?
- The practice phone number listed in the NPPES registry for Supreme Independence Room and Board is (313) 459-9538.
- Who is the authorized official for Supreme Independence Room and Board?
- The authorized official listed on Supreme Independence Room and Board's NPPES record is James Blake, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Supreme Independence Room and Board's NPI active?
- Yes — Supreme Independence Room and Board's NPI (1972267870) is active in the NPPES registry as of the last update on 2021-10-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.