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Organization

INTENSIVE COMMUNITY OUTREACH SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BERNARD L HEYWARD (PRESIDENT)
(804) 317-7777
Entity
Organization

Contact information

Practice address
501 E FRANKLIN ST, SUITE 516, RICHMOND, VA 23219-2322
(804) 317-7777
Mailing address
501 E FRANKLIN ST, SUITE 516, RICHMOND, VA 23219-2322
(804) 317-7777

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
118542
VA

Other

Enumeration date
08/05/2008
Last updated
08/05/2008
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