Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD EDWARDS (VP)
(919) 793-8898
Entity
Organization
Contact information
Practice address
314 CHAPANOKE RD, RALEIGH, NC 27603-3400
(919) 783-8898
Mailing address
5171 GLENWOOD AVE, APT 307, RALEIGH, NC 27612-3266
(919) 783-8898
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/14/2013
Last updated
01/15/2014
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