| Ebleak Inc. | |
|
1712 Airline Blvd Portsmouth VA 23707-3911 | |
| (757) 337-2457 | |
| Not Available |
| Full Name | Ebleak Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1712 Airline Blvd, Portsmouth, Virginia |
| Authorized Official Name and Position | Emily Leak (DIRECTOR) |
| Authorized Official Contact | 7573386086 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ebleak Inc. 1712 Airline Blvd Portsmouth VA 23707-3911 Ph: () - | Ebleak Inc. 1712 Airline Blvd Portsmouth VA 23707-3911 Ph: (757) 337-2457 |
| NPI Number | 1538589494 |
|---|---|
| Provider Enumeration Date | 04/18/2014 |
| Last Update Date | 04/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538589494 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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