Provider Demographics
NPI:1568779627
Name:SESSOMS FAMILY CARE HOME
Entity Type:Organization
Organization Name:SESSOMS FAMILY CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EUKITA
Authorized Official - Middle Name:BARCO
Authorized Official - Last Name:SESSOMS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:252-332-8313
Mailing Address - Street 1:336 JERNIGAN AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-9384
Mailing Address - Country:US
Mailing Address - Phone:252-332-8313
Mailing Address - Fax:
Practice Address - Street 1:336 JERNIGAN AIRPORT RD
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-9384
Practice Address - Country:US
Practice Address - Phone:252-332-8313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL047008261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care