Organization
EASTER SEALS UCP NC & VA, INC
Active
Other names
Easterseals UCP
Organization subpart
No
Provider details
NPI number
Authorized official
NASHEBA KEY-ALLRED (CREDENTIALING SPECIALIST)
(919) 865-8632
Entity
Organization
Contact information
Practice address
124 RIDGE RUN, MARSHVILLE, NC 28103-1363
(704) 624-3132
(704) 624-6939
Mailing address
5171 GLENWOOD AVE, SUITE 400, RALEIGH, NC 27612-3266
(919) 783-8898
(919) 782-5486
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
311Z00000X
Custodial Care Facility
—
—
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
08/06/2010
Last updated
08/20/2021
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