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Organization

EASTERN SHORE COMMUNITY MH MR SAS SERVICES BOARD

Active
Other names
Eastern Shore Behavioral Healthcare Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES A CANNON (EXECUTIVE DIRECTOR)
(757) 442-3636
Entity
Organization

Contact information

Practice address
19056 GREENBUSH RD, PARKSLEY, VA 23421
(757) 665-1260
(757) 665-4184
Mailing address
PO BOX 453, NASSAWADOX, VA 23413-0453
(757) 442-3636

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
10/13/2006
Last updated
11/05/2007
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