NPIMap

Organization Active NPI

Professonal Family Care Services, Inc

  • In Home Supportive Care Agency
  • Fayetteville, NC
National Provider Identifier
1871627919
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
PROFESSONAL FAMILY CARE SERVICES, INC
Practice address
1012 Pamalee Dr
Fayetteville, NC 28303
Phone
(910) 485-0085
Fax
(910) 485-0334
NPI assigned
Mar 14, 2007
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
Phone
(910) 485-0085

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

1012 Pamalee Dr
Fayetteville, NC 28303

Mailing address

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

Other practice location 1

122 Orchard Crest Cir
Sanford, NC 27332-1695
Phone (910) 485-0085

Other practice location 2

19 Susie Cir
Cameron, NC 28326-6596
Phone (910) 485-0085

Other practice location 3

1016 Patrick Dr
Fayetteville, NC 28314-5921
Phone (910) 485-0085

Other identifiers 1

IdentifierTypeStateIssuer
3408859MedicaidNC

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.

Locations

1012 Pamalee Dr
Fayetteville, NC 28303
Phone (910) 481-0560

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1871627919",
    "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": "1012 PAMALEE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28303",
            "telephone_number": "910-485-0085",
            "fax_number": "910-485-0334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "122 Orchard Crest Cir",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "NC",
            "postal_code": "273321695",
            "country_code": "US",
            "telephone_number": "910-485-0085",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19 Susie Cir",
            "address_purpose": "LOCATION",
            "city": "Cameron",
            "state": "NC",
            "postal_code": "283266596",
            "country_code": "US",
            "telephone_number": "910-485-0085",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1016 Patrick Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283145921",
            "country_code": "US",
            "telephone_number": "910-485-0085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROFESSONAL FAMILY CARE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "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",
        "authorized_official_telephone_number": "910-485-0085",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408859",
            "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.