SUPREME INDEPENDENCE ROOM AND BOARD
NPI 1972267870
Lodging in Detroit, MI

NPI Status: Active since October 26, 2021

Contact Information

12844 BROADSTREET AVE
DETROIT, MI
ZIP 48238
Phone: (313) 459-9538

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  • Organization
  • Lodging

About SUPREME INDEPENDENCE ROOM AND BOARD

This page provides the complete NPI Profile along with additional information for Supreme Independence Room And Board, a provider established in Detroit, Michigan operating as a Lodging. The healthcare provider is registered in the NPI registry with number 1972267870 assigned on October 2021. The practitioner's primary taxonomy code is 177F00000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Mr. James Blake (Owner)

NPI
1972267870
Provider Name
SUPREME INDEPENDENCE ROOM AND BOARD
Entity Type
Organization
Location Address
12844 BROADSTREET AVE DETROIT, MI 48238
Location Phone
(313) 459-9538
Mailing Address
36306 DOMINION CIR STERLING HEIGHTS, MI 48310
Mailing Phone
(810) 660-1892
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-26-2021
Last Update Date
10-26-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Lodging

Taxonomy Code
177F00000X
Type
Other Service Providers
Taxonomy Description
A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. JAMES BLAKE

Authorized Official Title
OWNER
Authorized Official Phone
(810) 660-1892

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1972267870
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
291424614814
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 1 + 4 + 2 + 4 + 6 + 1 + 4 + 8 + 1 + 4 + 24 = 70
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1972267870 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1972267870, enumerated in the NPI registry as an "organization" on October 26, 2021

The provider is located at 12844 Broadstreet Ave Detroit, Mi 48238 and the phone number is (313) 459-9538

This medical organization specializes in Lodging with taxonomy code 177F00000X

This NPI record was last updated on October 26, 2021. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.