Supreme Mental Wellness Limited Liability Company

NPI #1386477636 in Clinton, Maryland

Provider Information

NPI Number: 1386477636
Entity Type: Organization
Organization Name: Supreme Mental Wellness Limited Liability Company
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Aug 22, 2024
Last Updated: Aug 22, 2024

Practice Location

Address: 8222 SCHULTZ RD STE 102
City: Clinton
State: Maryland
ZIP Code: 20735-2607
Phone: (240) 486-1560

Authorized Official

Name: OLAKUNLE AYANWALE
Title: PRESIDENT
Phone: (240) 486-1560

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health	363LP0808X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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