| Easter Seals Ucp North Carolina & Virginia, Inc. | |
|
3608 University Dr Suite 101 Durham NC 27707-6260 | |
| (919) 433-0170 | |
| (919) 433-0156 |
| Full Name | Easter Seals Ucp North Carolina & Virginia, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3608 University Dr, Durham, North Carolina |
| Authorized Official Name and Position | Richard P Edwards (CONTRACT ADMINISTRATOR) |
| Authorized Official Contact | 9197838898 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Easter Seals Ucp North Carolina & Virginia, Inc. 5171 Glenwood Ave Suite 400 Raleigh NC 27612-3266 Ph: (919) 783-8898 | Easter Seals Ucp North Carolina & Virginia, Inc. 3608 University Dr Suite 101 Durham NC 27707-6260 Ph: (919) 433-0170 |
| NPI Number | 1568524031 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 11/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568524031 | NPI | - | NPPES |
| 5903290 | Medicaid | NC | |
| 018KJ | Other | NC | NC BCBS GROUP PROVIDER NU |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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