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
408 LITHIA INN RD, LINCOLNTON, NC 28092-4221
(704) 735-2126
Mailing address
5171 GLENWOOD AVE, SUITE 400, RALEIGH, NC 27612-3266
(919) 783-8898
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
311ZA0620X
Adult Care Home Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805034
—
NC
Enumeration date
01/29/2007
Last updated
03/10/2021
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