Easter Seals Ucp North Carolina 7 Virginia

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

EASTER SEALS UCP NORTH CAROLINA 7 VIRGINIA

Practice address

6135 Park South Dr
Charlotte, NC 28210-3272

Phone

(919) 783-8898

NPI assigned

Sep 24, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Richard Edwards

Title

VP

Phone

(919) 783-8898

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379980800000",
    "number": "1235565144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5171 GLENWOOD AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123266",
            "telephone_number": "919-783-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6135 PARK SOUTH DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103272",
            "telephone_number": "919-783-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS UCP NORTH CAROLINA 7 VIRGINIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-24",
        "last_updated": "2013-09-24",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "919-783-8898"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Easter Seals Ucp North Carolina & Virginia, Inc.
• Easter Seals Ucp North Carolina & Virginia, Inc.
• Easter Seals Ucp North Carolina & Virginia, Inc.
• Easter Seals Ucp North Carolina & Virginia, Inc.
• Easter Seals Ucp North Carolina & Virginia, Inc.
• Keyonte Easter, LCMHC-A
• Isabel Lacey Easterling, RD
• Easterseals Ucp
• Easterseals Ucp
• Easterseals Ucp North Carolina

• All providers in Charlotte, NC
• Mental Illness Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.