Organization
EASTERSEALS UCP OF NC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY SAUNDERS (AR SPECIALIST)
(704) 566-6040
Entity
Organization
Contact information
Practice address
2315 MYRON DR, RALEIGH, NC 27607-3344
(800) 662-7119
(919) 782-5486
Mailing address
5700 EXECUTIVE CENTER DR STE 110, CHARLOTTE, NC 28212-8833
(704) 566-6040
(704) 566-6050
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-036-068
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150662
CONTRACT ID FOR PATHWAYS
NC
Enumeration date
01/24/2007
Last updated
08/22/2020
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