Organization · Type 2 NPI
Supreme Independence Room and Board
Lodging Provider · Detroit, MI
NPI number
1972267870
Active
Practice location
12844 Broadstreet Ave
Detroit, MI 48238-3250
Mailing address
36306 Dominion Cir
Sterling Heights, MI 48310-7458
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Lodging Provider Primary | 177F00000X | None listed |
Lodging Provider: A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
Other lodging provider providers in Detroit
About NPI 1972267870
Supreme Independence Room and Board's National Provider Identifier is 1972267870, issued on Oct 26, 2021. The primary taxonomy on file is Lodging Provider (177F00000X), and the practice location is in Detroit, MI. The record was last updated on Oct 26, 2021.