NPIMap

Organization Active NPI

Professional Family Care Services, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Fayetteville, NC
National Provider Identifier
1508990094
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
MHL026699 Issued in NC
Legal business name
PROFESSIONAL FAMILY CARE SERVICES, INC.
Practice address
3581 Torbay Dr
Fayetteville, NC 28311-2462
Phone
(910) 480-9336
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL026699 NC Primary

Addresses

Primary practice location

3581 Torbay Dr
Fayetteville, NC 28311-2462

Mailing address

1012 Pamalee Dr
Fayetteville, NC 28303-3833
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": "1598054400000",
    "number": "1508990094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3581 TORBAY DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283112462",
            "telephone_number": "910-480-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL FAMILY CARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "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": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL026699",
            "primary": true
        }
    ],
    "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 Aug 22, 2020; 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.