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Organization
INTERCEPT YOUTH SERVICES, INC.
Active
Organization
INTERCEPT YOUTH SERVICES, INC.
Active
Other names
Spring House
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID RANDOLPH GRAHAM (DIR OF ACCOUNTING & ADMINISTRATION)
(804) 864-1320
Entity
Organization
Contact information
Practice address
2129 S PROVIDENCE RD, RICHMOND, VA 23236-2160
(804) 249-3350
(804) 249-3352
Mailing address
5511 STAPLES MILL RD, SUITE 102, RICHMOND, VA 23228-5445
(804) 864-1320
(804) 864-1323
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
295-14-011
VA
Other
Enumeration date
09/26/2006
Last updated
09/24/2020
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