# EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.

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

## Provider details

- **NPI number:** 1962717405
- **Authorized official:** RICHARD EDWARDS (CONTRACT ADMINISTRATOR)
- **Authorized official phone:** (919) 783-8898

## Contact information

- **Practice address:** 1417 HARPER AVE SW, LENOIR, NC 28645-5065
- **Practice address phone:** (828) 758-8316
- **Practice address fax:** (828) 758-8868
- **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 |
| --- | --- | --- | --- | --- |
| 3104A0625X | Assisted Living Facility (Mental Illness) | — | NULL | — |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 08/09/2010
- **Last updated:** 12/08/2015