Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD EDWARDS (CONTRACT ADMINISTRATOR)
(919) 783-8898
Entity
Organization
Contact information
Practice address
200 WEBB BLVD, HAVELOCK, NC 28532-1930
(252) 447-3892
Mailing address
5171 GLENWOOD AVE, SUITE 400, RALEIGH, NC 27612-3266
(919) 783-8898
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
01
—
8300073K
ECHOES CBRS NON MEDICAID
NC
05
—
8300073K
—
NC
Enumeration date
01/22/2007
Last updated
12/15/2015
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