# EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083918205
- **Authorized official:** MS. HEATHER BREWER (CONTRACT ADMINISTRATOR)
- **Authorized official phone:** (919) 783-8898

## Contact information

- **Practice address:** 5171 GLENWOOD AVE STE 400, RALEIGH, NC 27612-3266
- **Practice address phone:** (919) 783-8898
- **Mailing address:** 5171 GLENWOOD AVE, SUITE 400, RALEIGH, NC 27612-3266
- **Mailing address phone:** (919) 783-8898

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 01/03/2011
- **Last updated:** 01/12/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 8303450 | — | NC |