PROFESSIONAL FAMILY CARE SERVICES, INC. (NPI# 1760516306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760516306 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL FAMILY CARE SERVICES, INC. |
| Practice Address |
122 Orchard Crest Cir Sanford NC 27332-1695 |
| Mailing Address |
1012 Pamalee Dr Fayetteville NC 28303-3833 |
| Practice Telephone | 9194980223 |
| 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 | MHL043047 | 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 |
| 1508990094 | Professional Family Care Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3581 Torbay Dr, Fayetteville, NC 28311-2462 | 2007-03-15 |
| 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 |
| 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 |
122 ORCHARD CREST CIR |
| City | SANFORD |
| State | NC |
| Zip Code | 27332-1695 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932629847 | Jessica Lane Phillips | Specialist/Technologist | 17 Cypress Creek Farm Rd, Sanford, NC 27332 | 2017-06-21 |
| 1033557012 | Krishawn Davis-darby | Student in an Organized Health Care Education/Training Program | 5593 Olivia Rd, Sanford, NC 27332 | 2013-06-12 |
| 1144593898 | Fetima Marie Wellington | Counselor | 310 Timberline Dr, Sanford, NC 27332 | 2012-02-10 |
| 1740588383 | Food Lion, LLC | Durable Medical Equipment & Medical Supplies | 1655 Buffalo Lake Road, Sanford, NC 27332 | 2011-03-07 |
| 1912057282 | Susan Kay Byerly | Psychologist | 226 E Trade St, Sanford, NC 27332 | 2007-01-11 |
| 1265503601 | David A Edrington Dds Pa | Dentist | 420 West Main Street, Sanford, NC 27332 | 2006-11-09 |
| 1396840625 | Knecht Chiropractic Center PC | Chiropractor | 2631 South Horner Boulevard, Sanford, NC 27332 | 2006-09-13 |
| 1861446338 | Liberty Healthcare Group LLC | Skilled Nursing Facility | 310 Commerce Drive, Sanford, NC 27332 | 2006-05-20 |
| 1700863271 | Vincent Paul Vissichelli | Dentist | 73 Pineridge Cove, Sanford, NC 27332 | 2005-12-27 |
| 1992787832 | Tenet Central Carolina Physicians Inc | Internal Medicine | 4546 Hwy 87 S, Sanford, NC 27332 | 2005-11-16 |
| Find all providers in zip 27332 | ||||
| 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 |
|---|---|---|---|---|
| 1679104673 | Dynamic Alternative Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 171 Brook St, Sanford, ME 04073-2505 | 2020-01-29 |
| 1922254085 | Baptist Children's Homes of Nc Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1428 Carthage Street, Sanford, NC 27330-8986 | 2008-08-08 |
| 1386890440 | Baptist Childrens Homes of Nc Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1434 Carthage Street, Sanford, NC 27330-8986 | 2008-08-08 |
| 1205975653 | T.l.c. Home, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1775 Hawkins Ave, Sanford, NC 27330-6909 | 2007-02-05 |
| 1588760433 | Lee County Group Homes, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2412 Knollwood Dr, Lee # 2, Sanford, NC 27330-7671 | 2006-09-16 |
| 1407952344 | Lee County Group Homes, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3101 Carbonton Rd, Lee # 1, Sanford, NC 27330-8214 | 2006-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578160552 | Residential Option Serving Adolescents, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2316 Carved Tree Ln, Charlotte, NC 28262-3154 | 2020-10-03 |
| 1649895442 | Gaynelle Bolling | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 102 Mandarin Dr, Pikeville, NC 27863-0020 | 2020-06-08 |
| 1851913966 | Johnson Enrichment Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 221 Foxcroft Dr, Winston Salem, NC 27103-5313 | 2020-05-12 |
| 1881230795 | Walter Jason Young Jr. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 412 Rook Rd, Charlotte, NC 28216-3199 | 2019-11-26 |
| 1750935839 | Heavenly Touch Residential Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4720 Baileys Lake Rd Nw Apt 204, Concord, NC 28027-8576 | 2019-07-28 |
| 1073166245 | Making Kids Matter, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 409 Hunton Forest Dr Nw, Concord, NC 28027-0186 | 2019-07-17 |
| 1891357752 | New Hope for Tomorrow LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 528 Baldwin Rd, Burlington, NC 27217-1702 | 2019-07-01 |
| 1114490877 | Brenda Gail Cannon | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3105 Vico Ter, Raleigh, NC 27610-5951 | 2019-01-05 |
| 1356813455 | Lamesha Marshall | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3335 Avalon Ave, Charlotte, NC 28208-3378 | 2018-12-31 |
| 1487131074 | Ronald Anthony Benjamin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1594 Candace Ridge Dr, Greensboro, NC 27406-8595 | 2018-07-26 |
| Find all providers with the same taxonomy | ||||
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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.