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Easter Seals Ucp North Carolina

Organization Active NPI Adult Care Home Facility · Raleigh, NC

NPI 1336285394 · NPPES record last updated May 26, 2009

Key facts

NPI
1336285394
Entity type
Organization (NPI type 2)
Primary specialty
Adult Care Home Facility 311ZA0620X
Legal business name
EASTER SEALS UCP NORTH CAROLINA
Practice address
2315 Myron Dr
Raleigh, NC 27607-3344
Phone
(704) 566-6040
Fax
(704) 971-2537
NPI assigned
Jan 29, 2007
Organization subpart
No

Authorized official

Name
Mrs. Susan Tweed
Title
Controller
Phone
(704) 566-6040

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Easter Seals Ucp North Carolina Virginia Inc (224 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X Yes

Addresses

Primary practice location

2315 Myron Dr
Raleigh, NC 27607-3344

Mailing address

5700 Executive Center Dr
Suite 110
Charlotte, NC 28212-8858
Phone (704) 566-6040

Other identifiers

IdentifierTypeStateIssuer
7804663MedicaidNC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 26, 2009.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243296000000",
    "number": "1336285394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 EXECUTIVE CENTER DR",
            "address_2": "SUITE 110",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128858",
            "telephone_number": "704-566-6040",
            "fax_number": "704-971-2537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 MYRON DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276073344",
            "telephone_number": "704-566-6040",
            "fax_number": "704-971-2537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS UCP NORTH CAROLINA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2009-05-26",
        "status": "A",
        "authorized_official_last_name": "TWEED",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "704-566-6040",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804663",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

All providers in Raleigh, NC · Adult Care Home Facility in North Carolina

Sources for this page

Verify at the official NPI Registry.