OrganizationEaster Seals Ucp North Carolina & Virginia, Inc.Community/Behavioral HealthAgenciesPractice Address4000 Wake Forest Rd, Ste 200, Raleigh, NC 27609-6879(919) 861-1600(919) 783-8898PECOS EnrollmentBased on the most recent information from CMS, provider Easter Seals Ucp North Carolina & Virginia, Inc. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1871659706Provider TypeOrganizationFull NameEaster Seals Ucp North Carolina & Virginia, Inc.SubpartNoEnumeration Date12/28/2006Last Updated11/20/2015Contact InformationPractice LocationPractice Address4000 Wake Forest Rd, Ste 200, Raleigh, NC 27609-6879Phone(919) 861-1600Fax(919) 861-1637Mailing LocationMailing Address5171 Glenwood Ave, Suite 400, Raleigh, NC 27612-3266Phone(919) 783-8898Fax(919) 782-5486Authorized OfficialNameEdwards, Richard P (Contract Administrator)Phone(919) 783-8898Provider TaxonomiesCodeDescriptionLicenseCode251S00000XPrimaryDescriptionCommunity/Behavioral HealthAgenciesLicenseUnlisted IssuerCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID8300486HDescriptionMedicaidIssuerUnlistedNorth CarolinaID8300486FDescriptionMedicaidIssuerUnlistedNorth CarolinaID8300486BDescriptionMedicaidIssuerUnlistedNorth CarolinaID018KJDescriptionOtherIssuerBCBS GROUPNorth CarolinaID8300486DescriptionMedicaidIssuerUnlistedNorth CarolinaID8300486GDescriptionMedicaidIssuerUnlistedNorth CarolinaID8300486IDescriptionMedicaidIssuerUnlistedNorth CarolinaID8300486ADescriptionMedicaidIssuerUnlistedNorth Carolina