Southeastern United Care LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SOUTHEASTERN UNITED CARE LLC

Practice address

30 Drakes Branch Drive
Pembroke, NC 28372-7325

Phone

(910) 521-9557

Fax

(910) 521-0077

NPI assigned

Sep 15, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Demetrus Locklear, BA

Title

Agency Director

Phone

(910) 521-9557

Specialties & licenses 2

Addresses

Other identifiers 6

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1922093947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 159",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283720159",
            "telephone_number": "910-521-9557",
            "fax_number": "910-521-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 DRAKES BRANCH DRIVE",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283727325",
            "telephone_number": "910-521-9557",
            "fax_number": "910-521-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN UNITED CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-15",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "LOCKLEAR",
        "authorized_official_first_name": "DEMETRUS",
        "authorized_official_title_or_position": "AGENCY DIRECTOR",
        "authorized_official_telephone_number": "910-521-9557",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC 2923",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408256",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301697",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006401",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601239",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301697B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301697G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lavirsa Smith
• Megan Elizabeth Smith
• Southeastern Integrated Care
• Southeastern Regional Medical Center
• Southeastern Regional Physician Services
• Southeastern United Care, LLC
• Southeastern United Care,LLC
• Southeastern United Care,LLC
• Southeastern United Care,LLC
• Southern Grace Home Health Care Agency LLC

• Community/Behavioral Health Agency in Pembroke, NC
• Providers in Pembroke, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.