PROFESSONAL FAMILY CARE SERVICES, INC (NPI# 1871627919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871627919 |
| Entity Type | Organization |
| Organization Name | PROFESSONAL FAMILY CARE SERVICES, INC |
| Practice Address |
1012 Pamalee Dr Fayetteville NC 28303 |
| Mailing Address |
1012 Pamalee Drive Fayetteville NC 28303-4678 |
| Practice Telephone | 9104850085 |
| Practice Fax Number | 9104850334 |
| Mailing Telephone | 9104850085 |
| Mailing Fax Number | 9104850334 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2018-06-14 |
| 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 |
|---|---|---|---|---|---|
| N | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities | ||
| Y | 253Z00000X | In Home Supportive Care | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3408859 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1016 Patrick Dr, Fayetteville, NC 283145921 | 9104850085 | |
| 122 Orchard Crest Cir, Sanford, NC 273321695 | 9104850085 | |
| 19 Susie Cir, Cameron, NC 283266596 | 9104850085 |
| Street Address |
1012 PAMALEE DR |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396254702 | Miles 2 Wisdom LLC | Counselor | 1012 Pamalee Dr, Fayetteville, NC 28303-3833 | 2017-09-28 |
| 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 |
| 1306970454 | Professional Family Care Services, Inc | Case Management | 1012 Pamalee Dr, Fayetteville, NC 28303-3833 | 2007-03-14 |
| 1215061361 | Professional Family Care Services, Inc | Home Health | 1012 Pamalee Dr, Fayetteville, NC 28303-3833 | 2007-03-14 |
| 1124152277 | Professional Family Care Services, Inc | Home Health | 1012 Pamalee Dr, Fayetteville, NC 28303-3833 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404496 | Matthew Pace | Physician Assistant | Bldg 5-4257 Bastogne St, Fort Bragg, NC 28303 | 2020-07-20 |
| 1952920449 | Vonetta Bethea Jackson | Social Worker | 391 Wagoner Drive, Fayetteville, NC 28303 | 2020-04-14 |
| 1932746229 | Julie Harriss | Specialist/Technologist | Bldg E 4062, Canopy Lane, Fort Bragg, NC 28303 | 2019-12-05 |
| 1235780354 | Helen Delores Johnson | Technician | 261 Pierron Dr, Fayetteville, NC 28303 | 2019-09-20 |
| 1922655075 | Andrea Margaret Hutnam | Technician | 714 Shortridge Rd, Fayetteville, NC 28303 | 2019-08-23 |
| 1225695273 | Breona Lister | Dental Hygienist | 38 17 Gruber Rd, Fort Bragg, NC 28303 | 2019-05-24 |
| 1780148957 | Brian K Cox Sr. | Occupational Therapy Assistant | 5300 Ramsey St, Fayetteville, NC 28303 | 2019-01-22 |
| 1730670902 | Michael Sadtler | Counselor | 804 Stamper Rd Ste 101, Fayetteville, NC 28303 | 2018-05-23 |
| 1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
| 1154835577 | Jessica Bass Bosworth | Psychologist | 3415 Youngstown Dr, Fayetteville, NC 28303 | 2017-11-21 |
| Find all providers in zip 28303 | ||||
| Taxonomy Code | 253Z00000X |
| Grouping | Agencies |
| Classification | In Home Supportive Care |
| An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487252219 | Tera Campbell | In Home Supportive Care | 159 Dortmund Dr, Fayetteville, OH 45118-9406 | 2020-10-14 |
| 1568077485 | Pmp Home Care Agency Inc | In Home Supportive Care | 5329 Yadkin Rd Ste B, Fayetteville, NC 28303-3254 | 2020-09-09 |
| 1609481571 | Valley Care LLC | In Home Supportive Care | 2978 Cumberland Rd Ste 102, Fayetteville, NC 28306-2373 | 2020-09-08 |
| 1184236564 | Health & Home Services, Inc. | In Home Supportive Care | 2411 Robeson Street, Suite 100, Fayetteville, NC 28305-5577 | 2020-08-18 |
| 1609487487 | Living Private Home Care, LLC | In Home Supportive Care | 101 Devant St Ste 105a, Fayetteville, GA 30214-2711 | 2020-08-13 |
| 1518576289 | New Revelation Home Care LLC | In Home Supportive Care | 1500 Bragg Blvd Ste 104, Fayetteville, NC 28301-4289 | 2020-07-28 |
| 1063038792 | Dianna Marie Anderson | In Home Supportive Care | 101 Old Sandy Creek Rd Ste B, Fayetteville, GA 30214-4546 | 2020-06-18 |
| 1487279485 | A Clear Look Coaching Agency, LLC | In Home Supportive Care | 4582 Cumberland Rd Ste 104, Fayetteville, NC 28306-2416 | 2020-06-15 |
| 1679198899 | A Clear Look Coaching Agency, LLC | In Home Supportive Care | 910 Hay St, Fayetteville, NC 28305-5314 | 2020-06-12 |
| 1356965164 | Kedra Daniel | In Home Supportive Care | 435 Brenda Ln, Fayetteville, GA 30214-1505 | 2020-06-08 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
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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.