NPIMap

Easter Seals Ucp North Carolina & Virginia, Inc.

Organization Active NPI Community/Behavioral Health Agency · Greenville, NC

NPI 1689728313 · NPPES record last updated Jan 7, 2016

Key facts

NPI
1689728313
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.
Practice address
600 Lynndale CT
Suite F
Greenville, NC 27858-5443
Phone
(252) 353-7923
Fax
(252) 353-8001
NPI assigned
Jan 22, 2007
Organization subpart
No

Authorized official

Name
Mr. Richard Edwards
Title
Contract Administrator
Phone
(919) 783-8898

Corporate family (same tax ID) 24

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Yes

Addresses

Primary practice location

600 Lynndale CT
Suite F
Greenville, NC 27858-5443

Mailing address

5171 Glenwood Ave
Suite 400
Raleigh, NC 27612-3266
Phone (919) 783-8898

Other identifiers

IdentifierTypeStateIssuer
8300471BMedicaidNC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 7, 2016.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452124800000",
    "number": "1689728313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5171 GLENWOOD AVE",
            "address_2": "SUITE 400",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123266",
            "telephone_number": "919-783-8898",
            "fax_number": "919-782-5486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 LYNNDALE CT",
            "address_2": "SUITE F",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585443",
            "telephone_number": "252-353-7923",
            "fax_number": "252-353-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2016-01-07",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CONTRACT ADMINISTRATOR",
        "authorized_official_telephone_number": "919-783-8898",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300471B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

All providers in Greenville, NC · Community/Behavioral Health Agency in North Carolina

Sources for this page

Verify at the official NPI Registry.