Organization
EAST END INTENSIVE OUTPATIENT PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELINE COOPER WATKINS (MCAID COORDINATOR)
(757) 247-0039
Entity
Organization
Contact information
Practice address
2010 27TH ST, NEWPORT NEWS, VA 23607-4912
(757) 247-0039
(757) 247-0158
Mailing address
2010 27TH ST, NEWPORT NEWS, VA 23607-4912
(757) 247-0039
(757) 247-0158
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
320
VA
Other
Enumeration date
02/05/2007
Last updated
08/22/2020
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