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General NPI Number Information
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NPI Number | 1730998345
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Entity Type | Organization
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Legal Business Name | SAMJOGE COMPASSIONATE CARE SERVICES
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 4620 STORM CAT LN
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City | HOPE MILLS
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State | NC
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Zip | 28348-8098
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Country | US
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Telephone | 803-497-2893
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Fax |
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Provider Business Mailing Address
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Address Line | 4620 STORM CAT LN
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City | HOPE MILLS
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State | NC
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Zip | 28348-8098
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Country | US
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Telephone | 803-497-2893
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. SAMUEL DOTY SIEBO
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Credential | N/A
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Telephone | 803-497-2893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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