Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JELORE LITTLE (DIRECTOR, CONTRACTS & CREDENTIALING)
(336) 545-6338
Entity
Organization
Contact information
Practice address
2801 NEUSE BLVD, NEW BERN, NC 28562-2838
(252) 636-6007
(252) 636-3732
Mailing address
5171 GLENWOOD AVE, SUITE 211, RALEIGH, NC 27612-3266
(919) 783-8898
(919) 782-5486
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300385
—
NC
05
—
8300385B
—
NC
05
—
8300385H
—
NC
Enumeration date
01/22/2007
Last updated
10/03/2018
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