Provider Demographics
NPI:1770766735
Name:SOUTHEASTERN HEALTH CARE SERVICES, LLC
Entity type:Organization
Organization Name:SOUTHEASTERN HEALTH CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AGENCY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAY
Authorized Official - Middle Name:COVINGTON
Authorized Official - Last Name:MORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:910-997-6807
Mailing Address - Street 1:1219 ROCKINGHAM RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-4983
Mailing Address - Country:US
Mailing Address - Phone:910-997-6807
Mailing Address - Fax:910-997-6817
Practice Address - Street 1:1219 ROCKINGHAM RD
Practice Address - Street 2:SUITE 1
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4983
Practice Address - Country:US
Practice Address - Phone:910-997-6807
Practice Address - Fax:910-997-6817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care