# EASTER SEALS UCP NC & VA, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Easterseals UCP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942515572
- **Authorized official:** NASHEBA KEY-ALLRED (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (919) 865-8632

## Contact information

- **Practice address:** 124 RIDGE RUN, MARSHVILLE, NC 28103-1363
- **Practice address phone:** (704) 624-3132
- **Practice address fax:** (704) 624-6939
- **Mailing address:** 5171 GLENWOOD AVE, SUITE 400, RALEIGH, NC 27612-3266
- **Mailing address phone:** (919) 783-8898
- **Mailing address fax:** (919) 782-5486

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 3104A0625X | Assisted Living Facility (Mental Illness) | — | NULL | — |
| 311Z00000X | Custodial Care Facility | — | NULL | — |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 08/06/2010
- **Last updated:** 08/20/2021