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Organization

EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NASHEBA KEY-ALLRED (CREDENTIALING SPECIALIST)
(919) 865-8632
Entity
Organization

Contact information

Practice address
308 BRAGG ST NE, WILSON, NC 27893-3202
(252) 243-3022
Mailing address
5171 GLENWOOD AVE, SUITE 211, RALEIGH, NC 27612-3266
(919) 783-8898

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
311Z00000X
Custodial Care Facility
311ZA0620X
Adult Care Home Facility
Primary
MHL-098-169
NC

Other

Enumeration date
10/04/2011
Last updated
09/27/2018
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