Organization
EBLEAK INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EMILY LEAK (DIRECTOR)
(757) 338-6086
Entity
Organization
Contact information
Practice address
1712 AIRLINE BLVD, PORTSMOUTH, VA 23707-3911
(757) 337-2457
Mailing address
1712 AIRLINE BLVD, PORTSMOUTH, VA 23707-3911
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/18/2014
Last updated
04/18/2014
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