East End Intensive Outpatient Program

NPI 1013056167 - Community/Behavioral Health - 251S00000X

NPI Details
NPI 1013056167
Enumeration Date 02/05/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name JACQUELINE COOPER JACQUELINE
Position MCAID COORDINATOR
Phone (757) 247-0039
Fax (757) 247-0158
Practice Location
2010 27TH ST
NEWPORT NEWS VA, 23607-4912, US
Phone (757) 247-0039
Fax (757) 247-0158
Business Location
2010 27TH ST
NEWPORT NEWS VA, 23607-4912, US
Phone (757) 247-0039
Fax (757) 247-0158
Toxanomy
Taxonomy Code 251S00000X
License State Virginia
License Number 320
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According to our database, East End Intensive Outpatient Program NPI is 1013056167, taxonomy code is 251S00000X and license number is 320, license state is located at Virginia. East End Intensive Outpatient Program physically located at 2010 27th St, Newport News VA, 23607-4912. NPI Number 1033115704 has the healthcare provider type.

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1013056167 NPI number is provided on an as is basis without warranty of any kind. 1013056167 is maintained by the National Plan & Provider Enumeration System. The contents of East End Intensive Outpatient Program are for informational purposes only.