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
5171 GLENWOOD AVE STE 211, RALEIGH, NC 27612-3266
(919) 783-8898
(919) 782-5486
Mailing address
305 STONERIDGE BLVD, ASHEVILLE, NC 28804-8313
(828) 350-1111
(828) 658-9896
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
01
—
36117
WESTERN HIGHLANDS
NC
Enumeration date
03/13/2007
Last updated
12/02/2021
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