NPIMap

Organization Active NPI

Professional Family Care Services, Inc

  • In Home Supportive Care Agency
  • Fayetteville, NC
National Provider Identifier
1124152277
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
PROFESSIONAL FAMILY CARE SERVICES, INC
Practice address
1012 Pamalee Dr
Fayetteville, NC 28303-3833
Phone
(910) 485-0085
Fax
(910) 485-0334
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Authorized official

Name
Mr. Benson Otovo, MBA
Title
Executive Director
Phone
(910) 485-0085

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

1012 Pamalee Dr
Fayetteville, NC 28303-3833

Mailing address

PO Box 35150
Fayetteville, NC 28303-0150
Phone (910) 485-0085

Other identifiers 1

IdentifierTypeStateIssuer
6600534MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Professional Family Care Services Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1124152277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35150",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283030150",
            "telephone_number": "910-485-0085",
            "fax_number": "910-485-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 PAMALEE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033833",
            "telephone_number": "910-485-0085",
            "fax_number": "910-485-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL FAMILY CARE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "OTOVO",
        "authorized_official_first_name": "BENSON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "910-485-0085",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600534",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.