Organization
INTERCEPT YOUTH SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA ELENA WEAVER (OFFICE MANAGER)
(540) 523-8055
Entity
Organization
Contact information
Practice address
155 VALLEY ST NW, ABINGDON, VA 24210-2800
(804) 523-6202
Mailing address
5511 STAPLES MILL RD STE 102, RICHMOND, VA 23228-5445
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
601028709
—
VA
Enumeration date
01/12/2023
Last updated
01/12/2023
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