Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD EDWARDS (CONTRACT ADMINISTRATOR)
(919) 783-8898
Entity
Organization
Contact information
Practice address
2710 BURLWOOD DR, WINSTON SALEM, NC 27103-6204
(336) 768-8823
(336) 768-8550
Mailing address
5171 GLENWOOD AVE, SUITE 400, RALEIGH, NC 27612-3266
(919) 783-8898
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
10/13/2010
Last updated
12/21/2015
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