Organization
EASTER SEALS UCP NORTH CAROLINA& VIRGINIA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD P EDWARDS (CONTRACT ADMINISTRATOR)
(919) 783-8898
Entity
Organization
Contact information
Practice address
1503 WAYNE MEMORIAL DR, UNIT E, GOLDSBORO, NC 27534-2203
(919) 587-0001
(919) 587-0007
Mailing address
5171 GLENWOOD AVE, SUITE 400, RALEIGH, NC 27612-3266
(919) 783-8898
(919) 782-5486
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300746B
—
NC
05
—
8300746F
—
NC
05
—
8300746H
—
NC
05
—
8300746I
—
NC
Enumeration date
03/06/2009
Last updated
11/20/2015
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