NPIMap

Organization Active NPI

Professional Family Care Services, Inc

  • Community/Behavioral Health Agency
  • Fayetteville, NC
National Provider Identifier
1467532978
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PROFESSIONAL FAMILY CARE SERVICES, INC
Practice address
811 Stamper Rd Unit 4-5
Fayetteville, NC 28303-4215
Phone
(910) 485-0085
NPI assigned
Oct 17, 2006
Last updated
Oct 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 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/President
Phone
(910) 485-0085

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X MHL026894 NC
Community/Behavioral Health Agency 251S00000X Primary
Developmental Disabilities Clinic/Center 261QD1600X

Addresses

Primary practice location

811 Stamper Rd Unit 4-5
Fayetteville, NC 28303-4215

Mailing address

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

Other practice location 1

1012 Pamalee Dr
Fayetteville, NC 28303-3833
Phone (910) 485-0085

Other identifiers 1

IdentifierTypeStateIssuer
8301551BMedicaidNC

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": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1467532978",
    "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": "811 STAMPER RD UNIT 4-5",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034215",
            "telephone_number": "910-485-0085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1012 Pamalee Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283033833",
            "country_code": "US",
            "telephone_number": "910-485-0085",
            "fax_number": "910-485-0334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROFESSIONAL FAMILY CARE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "OTOVO",
        "authorized_official_first_name": "BENSON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/PRESIDENT",
        "authorized_official_telephone_number": "910-485-0085",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": "MHL026894",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301551B",
            "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 Oct 2, 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.