Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NASHEBA KEY-ALLRED (CONTRACT ADMINISTRATOR)
(919) 783-8898
Entity
Organization
Contact information
Practice address
4000 WAKE FOREST RD, STE 200, RALEIGH, NC 27609
(919) 784-9182
Mailing address
5171 GLENWOOD AVE, SUITE 211, RALEIGH, NC 27612-3266
(919) 783-8898
(919) 782-5486
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018KJ
NC BCBS GROUP HEALTHCHOIC
NC
05
—
8300672
—
NC
05
—
8300672A
—
NC
05
—
8300672B
—
NC
05
—
8300672C
—
NC
05
—
8300672D
—
NC
05
—
8300672F
—
NC
05
—
8300672G
—
NC
05
—
8300672H
—
NC
05
—
8300672I
—
NC
Enumeration date
12/15/2006
Last updated
06/04/2018
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