NPIMap

Organization Active NPI

Southeastern Wake Adult Day Center

  • Home Health Agency
  • Raleigh, NC
National Provider Identifier
1811192263
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
3408446 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
Jun 17, 2007
Last updated
Aug 26, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Authorized official

Name
Evelyn Sanders
Title
Executive Director
Phone
(919) 212-8580

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 3408446 NC Primary
Adult Day Care Clinic/Center 261QA0600X
Respite Care 385H00000X ORL-092-001 NC

Addresses

Primary practice location

3401 Carl Sandburg CT
Raleigh, NC 27610-2049

Mailing address

PO Box 46775
Raleigh, NC 27620-6775
Phone (919) 212-8580

Other identifiers 1

IdentifierTypeStateIssuer
3408446MedicaidNC

National Provider Directory

National Provider Directory
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.

NPI Registry JSON

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

{
    "created_epoch": "1182038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661472000000",
    "number": "1811192263",
    "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": "2007-06-17",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-212-8580"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "3408446",
            "primary": true
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NC",
            "license": "ORL-092-001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408446",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.