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Organization

SOUTHEASTERN UNITED CARE,LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DEMETRUS LOCKLEAR (OWNER)
(910) 521-9557
Entity
Organization

Contact information

Practice address
30 DRAKE'S BRANCH DRIVE, PEMBROKE, NC 28372-7325
(910) 521-9557
(910) 521-0077
Mailing address
P.O. BOX 159, PEMBROKE, NC 28372-0159
(910) 521-9557
(910) 521-0077

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC2923
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3408256
NC
Enumeration date
02/24/2009
Last updated
02/24/2009
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