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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 B.A. (AGENCY DIRECTOR/OWNER)
(910) 796-3350
Entity
Organization
Contact information
Practice address
215 RACINE DR, SUITE 204, WILMINGTON, NC 28403-8840
(910) 796-3350
(910) 796-3353
Mailing address
PO BOX 1585, SHALLOTTE, NC 28459-1585
(910) 796-3350
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6006400
—
NC
05
—
8302092
—
NC
05
—
8302092B
—
NC
05
—
8302092G
—
NC
Enumeration date
11/05/2007
Last updated
05/05/2009
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