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
3405 W WENDOVER AVE, SUITE C, GREENSBORO, NC 27407-2377
(336) 545-6338
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
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018KJ
NCBCBS
NC
05
—
830127C
—
NC
05
—
8301327
—
NC
05
—
8301327A
—
NC
05
—
8301327B
—
NC
05
—
8301327F
—
NC
05
—
8301327G
—
NC
05
—
8301327H
—
NC
05
—
8301327I
—
NC
Enumeration date
12/15/2006
Last updated
04/21/2017
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