NPIMap

Organization Active NPI

Professional Family Care Services, Inc.

  • In Home Supportive Care Agency
  • Fayetteville, NC
National Provider Identifier
1356475859
Registry record updated Dec 19, 2022
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
1016 Patrick Dr
Fayetteville, NC 28314-5921
Phone
(910) 487-9868
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary
Developmental Disabilities Clinic/Center 261QD1600X
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL026698 NC

Addresses

Primary practice location

1016 Patrick Dr
Fayetteville, NC 28314-5921

Mailing address

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

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": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671408000000",
    "number": "1356475859",
    "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": "1016 PATRICK DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283145921",
            "telephone_number": "910-487-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL FAMILY CARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "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
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL026698",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Dec 19, 2022; 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.