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Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA,INC.
Active
Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARDS RICHARD (VP SERVICE LINE)
(919) 865-8780
Entity
Organization
Contact information
Practice address
223 HULL RD, FAYETTEVILLE, NC 28303-5912
(910) 483-7283
Mailing address
5171 GLENWOOD AVE, SUITE 400, RALEIGH, NC 27612-3266
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
NULL
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
Other
Enumeration date
08/28/2013
Last updated
12/20/2013
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