Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGIINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT BEAVERS (CREDENTIALING MANAGER)
(919) 210-7661
Entity
Organization
Contact information
Practice address
201 E MAIN ST, SALEM, VA 24153-3893
(540) 777-7325
(540) 777-2194
Mailing address
5171 GLENWOOD AVE STE 211, RALEIGH, NC 27612-3266
(919) 783-8898
(919) 782-5486
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
09/30/2009
Last updated
01/18/2023
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