# EASTER SEALS UCP OF 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:** 1982919668
- **Authorized official:** NASHEBA KEY-ALLRED (CONTRACT ADMINISTRATOR)
- **Authorized official phone:** (919) 783-8898

## Contact information

- **Practice address:** 89 ASHLYN DR SE, CONCORD, NC 28025-3546
- **Practice address phone:** (704) 721-5912
- **Practice address fax:** (704) 721-5913
- **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:** 08/18/2010
- **Last updated:** 08/20/2021