Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD EDWARDS (CONTRACT ADMINISTRATOR)
(919) 783-8898
Entity
Organization
Contact information
Practice address
1300 GOLD ST N, WILSON, NC 27893-2302
(252) 291-5872
Mailing address
5171 GLENWOOD AVE, SUITE 400, RALEIGH, NC 27612-3266
(919) 783-8898
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
—
—
311ZA0620X
Adult Care Home Facility
Primary
MHL-098-168
NC
Other
Enumeration date
10/04/2011
Last updated
11/20/2015
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