| Easter Seals Ucp North Carolina & Virginia, Inc. | |
|
603 Long St West Jefferson NC 28694-8810 | |
| (336) 246-6504 | |
| (336) 246-6504 |
| Full Name | Easter Seals Ucp North Carolina & Virginia, Inc. |
|---|---|
| Speciality | Assisted Living Facility - Assisted Living, Mental Illness |
| Location | 603 Long St, West Jefferson, 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. 603 Long St West Jefferson NC 28694-8810 Ph: (336) 246-6504 |
| NPI Number | 1598070039 |
|---|---|
| Provider Enumeration Date | 08/09/2010 |
| Last Update Date | 09/24/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598070039 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 3104A0625X | Assisted Living Facility - Assisted Living, Mental Illness | (* (Not Available)) | Primary |
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