Organization
EASTERSEALS UCP NORTH CAROLINA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN TWEED (AR CONTROLLER)
(704) 566-6040
Entity
Organization
Contact information
Practice address
5700 EXECUTIVE CENTER DR, CHARLOTTE, NC 28212-8858
(704) 566-6040
Mailing address
2315 MYRON DR, RALEIGH, NC 27607-3344
(704) 566-6040
(704) 971-2537
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005283
—
NC
Enumeration date
02/21/2007
Last updated
05/22/2009
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