NPIMap

Organization Active NPI

Southeastern United Care,LLC

  • Community/Behavioral Health Agency
  • Pembroke, NC
National Provider Identifier
1043451305
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SOUTHEASTERN UNITED CARE,LLC
Practice address
30 Drakes Branch Drive
Pembroke, NC 28372-7325
Phone
(910) 521-9557
Fax
(910) 521-0077
NPI assigned
Mar 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Demetrus Locklear
Title
Owner
Phone
(910) 521-9557

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

30 Drakes Branch Drive
Pembroke, NC 28372-7325

Mailing address

PO Box 159
Pembroke, NC 28372-0159
Phone (910) 521-9557

Other identifiers 1

IdentifierTypeStateIssuer
6006401MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Southeastern United Care LLC17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1043451305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 159",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283720159",
            "telephone_number": "910-521-9557",
            "fax_number": "910-521-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 DRAKES BRANCH DRIVE",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283727325",
            "telephone_number": "910-521-9557",
            "fax_number": "910-521-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN UNITED CARE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-17",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "LOCKLEAR",
        "authorized_official_first_name": "DEMETRUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-521-9557"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006401",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.