# EASTER SEALS UCP NORTH CAROLINA & VIRGINIA,INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1386078244
- **Authorized official:** EDWARDS RICHARD (VP SERVICE LINE)
- **Authorized official phone:** (919) 865-8780

## Contact information

- **Practice address:** 223 HULL RD, FAYETTEVILLE, NC 28303-5912
- **Practice address phone:** (910) 483-7283
- **Mailing address:** 5171 GLENWOOD AVE, SUITE 400, RALEIGH, NC 27612-3266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | NULL | Yes |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | — | Yes |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 08/28/2013
- **Last updated:** 12/20/2013