Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NASHEBA KEY-ALLRED (CONTRACT SPECIALIST)
(919) 783-8898
Entity
Organization
Contact information
Practice address
1142 NORTH ANDY GRIFFITH PARKWAY, MOUNT AIRY, NC 27030-2954
(336) 789-9492
(336) 789-9587
Mailing address
5171 GLENWOOD AVE, STE 211, RALEIGH, NC 27612-3266
(919) 783-8898
(919) 782-5486
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408598
—
NC
Enumeration date
04/07/2011
Last updated
04/24/2017
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