Provider Demographics
NPI:1730998345
Name:SAMJOGE COMPASSIONATE CARE SERVICES
Entity type:Organization
Organization Name:SAMJOGE COMPASSIONATE CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:DOTY
Authorized Official - Last Name:SIEBO
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:803-497-2893
Mailing Address - Street 1:4620 STORM CAT LN
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-8098
Mailing Address - Country:US
Mailing Address - Phone:803-497-2893
Mailing Address - Fax:
Practice Address - Street 1:4620 STORM CAT LN
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-8098
Practice Address - Country:US
Practice Address - Phone:803-497-2893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness