| Professional Family Care Services, Inc | |
|
811 Stamper Rd Unit 4-5 Fayetteville NC 28303-4215 | |
| (910) 485-0085 | |
| Not Available |
| Full Name | Professional Family Care Services, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 811 Stamper Rd Unit 4-5, Fayetteville, North Carolina |
| Authorized Official Name and Position | Benson Otovo (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9104850085 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Family Care Services, Inc Po Box 35150 Fayetteville NC 28303-0150 Ph: (910) 485-0085 | Professional Family Care Services, Inc 811 Stamper Rd Unit 4-5 Fayetteville NC 28303-4215 Ph: (910) 485-0085 |
| NPI Number | 1679799183 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 12/19/2022 |
| Certification Date | 12/19/2022 |
| Medicare PECOS PAC ID | 2567532096 |
|---|---|
| Medicare Enrollment ID | O20080610000194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679799183 | NPI | - | NPPES |
| 6006010 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Leon Slocumb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598969347 PECOS PAC ID: 0042388266 Enrollment ID: I20081008000396 |
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