Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NASHEBA KEY-ALLRED (CONTRACT ADMINISTRATOR)
(919) 783-8898
Entity
Organization
Contact information
Practice address
4130 OLEANDER DR, SUITE 100, WILMINGTON, NC 28403-6843
(910) 790-5921
Mailing address
5171 GLENWOOD AVE, SUITE 211, RALEIGH, NC 27612-3266
(919) 783-8898
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
—
8300592A
—
NC
05
—
8300592B
—
NC
05
—
8300592G
—
NC
05
—
8300592H
—
NC
05
—
8300592I
—
NC
Enumeration date
01/22/2007
Last updated
04/21/2017
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