Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NASHEBA KEY-ALLRED (CREDENTIALING SPECIALIST)
(919) 865-8632
Entity
Organization
Contact information
Practice address
5171 GLENWOOD AVE, SUITE 400, RALEIGH, NC 27612
(919) 783-8898
(919) 782-5486
Mailing address
5171 GLENWOOD AVE, SUITE 400, RALEIGH, NC 27612-3266
(919) 783-8898
(919) 782-5486
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NC
251C00000X
Developmentally Disabled Services Day Training Agency
—
NC
251S00000X
Community/Behavioral Health Agency
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408598
—
NC
Enumeration date
11/30/2006
Last updated
10/08/2021
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