PROFESSIONAL FAMILY CARE SERVICES, INC. (NPI# 1508990094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508990094 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL FAMILY CARE SERVICES, INC. |
| Practice Address |
3581 Torbay Dr Fayetteville NC 28311-2462 |
| Mailing Address |
1012 Pamalee Dr Fayetteville NC 28303-3833 |
| Practice Telephone | 9104809336 |
| Mailing Telephone | 9104850085 |
| Mailing Fax Number | 9104850334 |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. BENSON OTOVO (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9104850085 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MHL026699 | NC | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831403344 | Professional Family Care Services, Inc. | Community/Behavioral Health | 111 Lamon Street, Suite 114, Fayetteville, NC 28301-4901 | 2010-07-27 |
| 1477709269 | Professional Family Care Services, Inc. | Early Intervention Provider Agency | 937 Menoher Blvd, Johnstown, PA 15905-2838 | 2008-08-12 |
| 1073647392 | Professional Family Care Services, Inc. | Clinic/Center | 350 Wagoner Dr, Suite 103, Fayetteville, NC 28303-4678 | 2007-03-16 |
| 1356475859 | Professional Family Care Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1016 Patrick Dr, Fayetteville, NC 28314-5921 | 2007-03-15 |
| 1336273994 | Professional Family Care Services, Inc. | Clinic/Center | 1002 Carthage St, Sanford, NC 27330-4115 | 2007-03-15 |
| 1760516306 | Professional Family Care Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 122 Orchard Crest Cir, Sanford, NC 27332-1695 | 2007-03-15 |
| 1952435521 | Professional Family Care Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6324 Stoney Point Loop, Fayetteville, NC 28306-9349 | 2007-03-15 |
| 1467772251 | Professional Family Care Services, Inc. | Case Management | 4441 Bragg Blvd, Fayetteville, NC 28303 | 2010-06-03 |
| 1427178581 | Professional Family Care Services, Inc. | Case Management | 1012 Pamalee Dr, Fayetteville, NC 28303-3833 | 2007-03-30 |
| 1841314200 | Professional Family Care Services, Inc. | Case Management | 1012 Pamalee Dr, Fayetteville, NC 28303-3833 | 2007-03-19 |
| Street Address |
3581 TORBAY DR |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28311-2462 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548692718 | The Loving Home, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3581 Torbay Dr, Fayetteville, NC 28311-2462 | 2013-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700415205 | Marcella Eubanks | Physical Therapy Assistant | Rdl Therapeutic Outpatient Therapy, 424 Mcarthur Rd, Fayetteville, NC 28311 | 2020-04-06 |
| 1144856709 | Laura Johnson | Occupational Therapy Assistant | 424 Mcarthur Rd., Fayetteville, NC 28311 | 2020-03-16 |
| 1326507096 | Senior Transportationl.l.c. | Private Vehicle | 164 Tallstone Dr, Fayetteville, NC 28311 | 2019-03-13 |
| 1154850998 | Shannon Marcella Chapman | Physical Therapist | 4140 Ramsey St Ste 110, Fayetteville, NC 28311 | 2017-06-06 |
| 1306392048 | Gena Oxendine | Counselor | 223 Glenola St, Fayetteville, NC 28311 | 2016-09-01 |
| 1023564010 | Rachel Sokolowski | Physical Therapy Assistant | 231 Treetop Dr., Fayetteville, NC 28311 | 2016-08-30 |
| 1285984765 | Towanaka Yvette Bass | Home Health Aide | 5688 Dobson Drive, Fayetteville, NC 28311 | 2012-09-12 |
| 1255574448 | Amy E. Southworth | Occupational Therapist | 3409 Connection Rd, Fayetteville, NC 28311 | 2009-04-17 |
| 1922246818 | Calhoun Family Pharmacy Inc | Pharmacy | 4417 Ramsey Street, Fayetteville, NC 28311 | 2009-01-30 |
| 1003051210 | Us Army | Clinic/Center | 5587 Lockridge Road, Fayetteville, NC 28311 | 2008-12-03 |
| Find all providers in zip 28311 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841612215 | Ravenwood | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 190 Bonney Ln, Fayetteville, NC 28306-3736 | 2014-01-20 |
| 1508288218 | Teresa Mcneill | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3608 Pickerel St, Fayetteville, NC 28306 | 2014-01-15 |
| 1750713921 | The Loving Home, Inc. #4 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1710 Scampton Dr, Fayetteville, NC 28303-3742 | 2013-07-30 |
| 1336580620 | Sophia B. Pierce & Associates, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1128 Paddington Pl, Fayetteville, NC 28314-6304 | 2013-07-15 |
| 1730457458 | Georgia Community Living Facilities LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 500 Lanier Ave W Ste 610, Fayetteville, GA 30214-7644 | 2011-12-08 |
| 1720398282 | Joyful Living Group Home #3 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2809 Eldorado Rd, Fayetteville, NC 28306-1916 | 2010-10-18 |
| 1518274695 | Cyshelle Williams | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4604 Pine Needle Ct, Fayetteville, NC 28314-2463 | 2010-09-09 |
| 1639322472 | Joyful Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6125 Louise St, Fayetteville, NC 28314-2720 | 2008-10-24 |
| 1326291246 | Joyful Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1951 Ireland Dr, Fayetteville, NC 28304-1504 | 2008-10-23 |
| 1366699415 | Stepping Stones Group Homes, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1446 Pamalee Drive, Fayetteville, NC 28303 | 2008-08-20 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28311 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.