Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JELORE LITTLE (CONTRACT ADMINISTRATOR)
(336) 545-6338
Entity
Organization
Contact information
Practice address
2563 ERIC LN, SUITE K, BURLINGTON, NC 27215-4303
(336) 223-0444
(336) 223-0449
Mailing address
5171 GLENWOOD AVE, SUITE 400, RALEIGH, NC 27612-3266
(919) 783-8898
(919) 782-5486
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018KJ
BCBS
NC
05
—
8301523
—
NC
Enumeration date
05/14/2007
Last updated
07/12/2019
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