# EASTER SEALS UCP NORTH CAROLINA

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

## Provider details

- **NPI number:** 1417093428
- **Authorized official:** MRS. SUSAN TWEED (CONTROLLER)
- **Authorized official phone:** (704) 566-6040

## Contact information

- **Practice address:** 2315 MYRON DR, RALEIGH, NC 27607-3344
- **Practice address phone:** (704) 566-6040
- **Practice address fax:** (704) 971-2537
- **Mailing address:** 5700 EXECUTIVE CENTER DR, SUITE 110, CHARLOTTE, NC 28212-8858
- **Mailing address phone:** (704) 566-6040
- **Mailing address fax:** (704) 971-2537

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 01/29/2007
- **Last updated:** 05/20/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7801332 | — | NC |