| Organization Name: | EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC. |
| NPI Number: | 1437367174 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RICHARD P EDWARDS (CONTRACT ADMINISTRATOR) |
| Mailing Address: | 1076 Nc Highway 86 N Yanceyville |
| State: | NC US |
| Postal Code: | 273798645 |
| Phone Number: | 3366941487 |
| Fax Number: | 3366941681 |
| NPI Enumeration Date: | 05/18/2007 |
| NPI Last Update Date: | 11/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |