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
4600 MOCKINGBIRD LN, WILMINGTON, NC 28409-5617
(910) 313-6653
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
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
MHL-065-223
NC
311ZA0620X
Adult Care Home Facility
—
—
Other
Enumeration date
04/28/2011
Last updated
09/24/2018
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