Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT BEAVERS (CREDENTIALING MANAGER)
(919) 210-7661
Entity
Organization
Contact information
Practice address
350 PEACE ST, NORTH WILKESBORO, NC 28659-4550
(336) 838-0511
(336) 838-5330
Mailing address
5171 GLENWOOD AVE, SUITE 211, RALEIGH, NC 27612-3266
(919) 783-8898
(919) 782-5486
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
311Z00000X
Custodial Care Facility
—
—
Other
Enumeration date
08/09/2010
Last updated
03/13/2023
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