| Easter Seals Ucp North Carolina | |
|
3405 W Wendover Ave Ste H Greensboro NC 27407-1525 | |
| (336) 272-9602 | |
| Not Available |
| Full Name | Easter Seals Ucp North Carolina |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3405 W Wendover Ave Ste H, Greensboro, North Carolina |
| Authorized Official Name and Position | Nasheba Yvette 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 5700 Executive Center Dr Suite 110 Charlotte NC 28212-8858 Ph: (704) 566-6040 | Easter Seals Ucp North Carolina 3405 W Wendover Ave Ste H Greensboro NC 27407-1525 Ph: (336) 272-9602 |
| NPI Number | 1962556696 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 03/09/2021 |
| Certification Date | 03/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962556696 | NPI | - | NPPES |
| 8301056B | Medicaid | NC | |
| 8301056G | Medicaid | NC | |
| 8301056H | Medicaid | NC | |
| 8301056I | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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