Organization
EAST COAST FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMAR LEVELL JOHNSON (EXECUTIVE OFFICER)
(412) 657-0606
Entity
Organization
Contact information
Practice address
259 GRANBY ST., NORFOLK, VA 23510
(412) 657-0606
(757) 514-8586
Mailing address
259 GRANBY ST., NORFOLK, VA 23510
(412) 657-0606
(757) 514-8586
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2405
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2405
—
VA
Enumeration date
06/24/2016
Last updated
01/25/2019
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