NPIMap

Organization Active NPI

Southeastern United Care LLC

  • Community/Behavioral Health Agency
  • Whiteville, NC
National Provider Identifier
1134309529
Registry record updated May 12, 2008
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
138 Memory PLZ
Whiteville, NC 28472-2640
Phone
(910) 640-1216
Fax
(910) 640-1309
NPI assigned
Nov 14, 2007
Last updated
May 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
Mr. Demetrus Locklear, B.A.
Title
Agency Director/Owner
Phone
(910) 521-9557

Specialties & licenses 1

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

Addresses

Primary practice location

138 Memory PLZ
Whiteville, NC 28472-2640

Mailing address

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

Other identifiers 4

IdentifierTypeStateIssuer
8302090BMedicaidNC
8302090GMedicaidNC
6006399MedicaidNC
8302090MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1134309529",
    "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": "138 MEMORY PLZ",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284722640",
            "telephone_number": "910-640-1216",
            "fax_number": "910-640-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN UNITED CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "LOCKLEAR",
        "authorized_official_first_name": "DEMETRUS",
        "authorized_official_title_or_position": "AGENCY DIRECTOR/OWNER",
        "authorized_official_telephone_number": "910-521-9557",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.A."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302090B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302090G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006399",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302090",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.