Organization
EASTER SEALS UCP NORTH CAROLINA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN TWEED (CONTROLLER)
(704) 566-6040
Entity
Organization
Contact information
Practice address
2315 MYRON DR, RALEIGH, NC 27607-3344
(704) 566-6040
(704) 971-2537
Mailing address
5700 EXECUTIVE CENTER DR, SUITE 110, CHARLOTTE, NC 28212-8858
(704) 566-6040
(704) 971-2537
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300075G
—
NC
01
—
8300075K
ECHOES CBRS NON MEDICAID
NC
05
—
8300075K
—
NC
Enumeration date
01/22/2007
Last updated
06/05/2009
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