Southeastern Wake Adult Day Center

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HC2279 Issued in NC

Legal business name

SOUTHEASTERN WAKE ADULT DAY CENTER

Practice address

3401 Carl Sandburg CT
Raleigh, NC 27610-2049

Phone

(919) 212-8580

Fax

(919) 212-8581

NPI assigned

Jan 22, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Evelyn Lane Sanders, LCSW

Title

Executive Director

Phone

(919) 212-8580

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Southeastern Adult Day Center Doing business as

Tax ID family

Southeastern Wake Adult Day Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Southeastern Wake Adult Day Center

  • Home Health Agency
  • Raleigh, NC
  • NPI 1598816381
  NPD tax ID
• Southeastern Wake Adult Day Center

  • Home Health Agency
  • Raleigh, NC
  • NPI 1811192263
  NPD tax ID

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

{
    "created_epoch": "1453420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453420800000",
    "number": "1699132571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 46775",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276206775",
            "telephone_number": "919-212-8580",
            "fax_number": "919-212-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CARL SANDBURG CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276102049",
            "telephone_number": "919-212-8580",
            "fax_number": "919-212-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN WAKE ADULT DAY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-22",
        "last_updated": "2016-01-22",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_middle_name": "LANE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-212-8580",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC2164",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC2279",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC2402",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600825",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006326",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408446",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeastern Adult Day Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southeastern Healthcare of North Carolina, Inc.
• Southeastern Imaging Consultants, LLC
• Southeastern Orthopedics Sports Medicine & Shoulder Center PA
• Southeastern Residential Services of NC
• Southeastern Wake Adult Day Center
• Southeastern Wake Adult Day Center
• Southern Dermatology, P.a.
• Southern Eye Associates, PA
• Southern Eye Associates, PA
• Southern Home Care Services, Inc

• Home Health Agency in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Home Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; 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.