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Organization
INTERCEPT YOUTH SERVICES, INC.
Active
Organization
INTERCEPT YOUTH SERVICES, INC.
Active
Other names
Providence House
Organization subpart
No
Provider details
NPI number
Authorized official
YOLANDA WINFIELD (REVENUE CYCLE MANAGER)
(804) 807-1201
Entity
Organization
Contact information
Practice address
2241 S PROVIDENCE RD, RICHMOND, VA 23236-2159
(804) 497-7900
(804) 497-7902
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
295-14-006
VA
Other
Enumeration date
09/26/2006
Last updated
11/19/2024
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