Organization
INTERCEPT YOUTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOLANDA WINFIELD (REVENUE CYCLE MANAGER)
(804) 807-1201
Entity
Organization
Contact information
Practice address
410 ADKINS RD, NORTH CHESTERFIELD, VA 23236-2833
(804) 440-3700
(804) 440-3711
Mailing address
5511 STAPLES MILL RD STE 102, RICHMOND, VA 23228-5445
(804) 440-3700
(804) 440-3711
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
29514021
VA
Other
Enumeration date
01/18/2012
Last updated
06/10/2024
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