PROFESSIONAL FAMILY CARE SERVICES, INC. (NPI# 1356475859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356475859 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL FAMILY CARE SERVICES, INC. |
| Practice Address |
1016 Patrick Dr Fayetteville NC 28314-5921 |
| Mailing Address |
1012 Pamalee Dr Fayetteville NC 28303-3833 |
| Practice Telephone | 9104879868 |
| 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 | MHL026698 | 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 |
| 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 |
1016 PATRICK DR |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28314-5921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528677812 | Lamonica Laveta Greene | Massage Therapist | 7804 Loxley Drive, Fayetteville, NC 28314 | 2020-07-23 |
| 1467086496 | The Pair Center for Couples Counseling Pllc | Counselor | 5085 Morganton Road, Suite 300, Fayetteville, NC 28314 | 2020-02-28 |
| 1346898335 | Chaitanya Joopally Dds Pllc | Dentist | 2050 Skibo Rd. Ste 104, Fayetteville, NC 28314 | 2019-09-03 |
| 1780231894 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 2360 Williamwood Lane, Fayetteville, NC 28314 | 2019-08-22 |
| 1164075982 | A Touch of Grace Inc | Day Training/Habilitation Specialist | 2153 Heathcote Drive, Fayetteville, NC 28314 | 2019-07-21 |
| 1093284465 | Candice Gorremans | Physician Assistant | 108th Air Defense Artillery Brigade, Fort Bragg, NC 28314 | 2018-11-15 |
| 1861983439 | Jessica Lynne Smith | Counselor | 6885 Cliffdale Rd Ste 2002, Fayetteville, NC 28314 | 2018-05-19 |
| 1073003752 | Gooden Mobile Pod Nc Pllc | Podiatrist | 311 Mcfadyen Dr, Fayetteville, NC 28314 | 2018-05-17 |
| 1093222101 | Lauren Bonneau | Behavioral Analyst | 6985 Nexus Ct, Suite 107, Fayetteville, NC 28314 | 2018-01-10 |
| 1760900153 | Elali Alisha Marie Moukwa | Dentist | 1916 Skibo Rd Ste C3, Fayetteville, NC 28314 | 2017-09-06 |
| Find all providers in zip 28314 | ||||
| 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 | 28314 |
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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.