Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD EDWARDS (VP)
(919) 783-8898
Entity
Organization
Contact information
Practice address
624 S FAYETTEVILLE ST, SUITE D, ASHEBORO, NC 27203-6581
(336) 318-2953
(336) 318-2958
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8303047
—
NC
05
—
8303047A
—
NC
Enumeration date
07/22/2010
Last updated
08/10/2011
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