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Organization
SOUTHEASTERN UNITED CARE LLC
Active
Organization
SOUTHEASTERN UNITED CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEMETRUS LOCKLEAR BA (AGENCY DIRECTOR OWNER)
(910) 521-9557
Entity
Organization
Contact information
Practice address
213 W CRONLY ST, LAURINBURG, NC 28352-3637
(910) 276-7635
(910) 276-7603
Mailing address
PO BOX 159, PEMBROKE, NC 28372-0159
(910) 521-9557
(910) 521-0077
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
HC3129
NC
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6006402
—
NC
05
—
8302154
—
NC
05
—
8302154B
—
NC
05
—
8302154G
—
NC
05
—
8302154H
—
NC
Enumeration date
12/18/2007
Last updated
05/12/2008
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