| Easter Seals Ucp North Carolina & Virginia, Inc. | |
|
408 Lithia Inn Rd Lincolnton NC 28092-4221 | |
| (704) 735-2126 | |
| Not Available |
| Full Name | Easter Seals Ucp North Carolina & Virginia, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 408 Lithia Inn Rd, Lincolnton, North Carolina |
| Authorized Official Name and Position | Nasheba Key-allred (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 9198658632 |
| 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. 408 Lithia Inn Rd Lincolnton NC 28092-4221 Ph: (704) 735-2126 |
| NPI Number | 1730225723 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 03/10/2021 |
| Certification Date | 03/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730225723 | NPI | - | NPPES |
| 7805034 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 311ZA0620X | Custodial Care Facility - Adult Care Home | (* (Not Available)) | Secondary |
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