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Organization

EASTER SEALS UCP NC & VA, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TANITA COX (ENROLLMENT COORDINATOR)
(919) 865-8780
Entity
Organization

Contact information

Practice address
314 CHAPONOKE ROAD, RALEIGH, NC 27603-3400
(919) 773-2020
(919) 773-1044
Mailing address
5171 GLENWOOD AVENUE, STE 400, RALEIGH, NC 27612
(919) 783-8898
(919) 865-8781

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8300071K
ECHOES CBRS NON MEDICAID
NC
05
8300071K
NC
Enumeration date
01/22/2007
Last updated
10/17/2014
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