# INTERCEPT YOUTH SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence House
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487755922
- **Authorized official:** YOLANDA WINFIELD (REVENUE CYCLE MANAGER)
- **Authorized official phone:** (804) 807-1201

## Contact information

- **Practice address:** 2241 S PROVIDENCE RD, RICHMOND, VA 23236-2159
- **Practice address phone:** (804) 497-7900
- **Practice address fax:** (804) 497-7902
- **Mailing address:** 5511 STAPLES MILL RD, SUITE 102, RICHMOND, VA 23228-5445
- **Mailing address phone:** (804) 864-1320
- **Mailing address fax:** (804) 864-1323

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 295-14-006 | VA | Yes |

## Other

- **Enumeration date:** 09/26/2006
- **Last updated:** 11/19/2024