| Supreme Treatment Center Inc | |
|
9175 Guilford Rd Ste 300 Columbia MD 21046-2565 | |
| (301) 213-2129 | |
| Not Available |
| Full Name | Supreme Treatment Center Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 9175 Guilford Rd Ste 300, Columbia, Maryland |
| Authorized Official Name and Position | Fobella Anyiji Nzobella (PROVIDER) |
| Authorized Official Contact | 3012132129 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Supreme Treatment Center Inc 9175 Guilford Rd Ste 300 Columbia MD 21046-2565 Ph: (301) 213-2129 | Supreme Treatment Center Inc 9175 Guilford Rd Ste 300 Columbia MD 21046-2565 Ph: (301) 213-2129 |
| NPI Number | 1881494961 |
|---|---|
| Provider Enumeration Date | 03/17/2025 |
| Last Update Date | 03/17/2025 |
| Certification Date | 03/11/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881494961 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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