NPIMap

Organization Active NPI

Comforcare Senior Services

  • Personal Care Attendant
  • Lumberton, NC
National Provider Identifier
1053497404
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
HC3342 Issued in NC
Legal business name
COMFORCARE SENIOR SERVICES
Practice address
2003 N Pine St Ste B
Lumberton, NC 28358-3935
Phone
(910) 272-0121
Fax
(910) 272-0141
NPI assigned
Oct 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Authorized official

Name
Diane Surgeon, JD
Title
Ceo
Phone
(910) 272-0121

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Personal Care AttendantGroup: 193200000X MULTI-SPECIALTY GROUP 3747P1801X HC3342 NC Primary

Addresses

Primary practice location

2003 N Pine St Ste B
Lumberton, NC 28358-3935

Mailing address

405 Dunn Rd
Lumberton, NC 28358-7913
Phone (910) 272-0121

Other identifiers 5

IdentifierTypeStateIssuer
3418102MedicaidNC
6601465MedicaidNC
8301840GMedicaidNC
8301840BMedicaidNC
8301840MedicaidNC

Other names 1

  • Southeastern Home Health Care Services, Inc. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Southeastern Home Health Care Services Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

2003 N Pine St
#B
Lumberton, NC 28358
Phone (910) 272-0121

NPI Registry JSON

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

{
    "created_epoch": "1161993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390348800000",
    "number": "1053497404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 DUNN RD",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283587913",
            "telephone_number": "910-272-0121",
            "fax_number": "910-272-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 N PINE ST STE B",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583935",
            "telephone_number": "910-272-0121",
            "fax_number": "910-272-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORCARE SENIOR SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-28",
        "last_updated": "2014-01-22",
        "status": "A",
        "authorized_official_last_name": "SURGEON",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-272-0121",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": "NC",
            "license": "HC3342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418102",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601465",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301840G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301840B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301840",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeastern Home Health Care Services, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.