| Easter Seals Ucp North Carolina & Virgina, Inc. | |
|
414 W Lebanon St Mount Airy NC 27030-2954 | |
| (336) 789-9492 | |
| (336) 789-9587 |
| Full Name | Easter Seals Ucp North Carolina & Virgina, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 414 W Lebanon St, Mount Airy, North Carolina |
| Authorized Official Name and Position | Brett Beavers (CREDENTIALING MANAGER) |
| Authorized Official Contact | 9192107661 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Easter Seals Ucp North Carolina & Virgina, Inc. 5171 Glenwood Ave Suite 211 Raleigh NC 27612-3266 Ph: (919) 783-8898 | Easter Seals Ucp North Carolina & Virgina, Inc. 414 W Lebanon St Mount Airy NC 27030-2954 Ph: (336) 789-9492 |
| NPI Number | 1033271978 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 09/20/2021 |
| Certification Date | 09/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033271978 | NPI | - | NPPES |
| 8300674A | Medicaid | NC | |
| 8300674I | Medicaid | NC | |
| 018KJ | Other | NC | NC BCBS |
| 8300674F | Medicaid | NC | |
| 8300674G | Medicaid | NC | |
| 8300674 | Medicaid | NC | |
| 8300674H | Medicaid | NC | |
| 8300674B | Medicaid | NC |
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