Organization
THE INDEPENDENT CAPACITY SYSTEM, INC.
Active
Organization
THE INDEPENDENT CAPACITY SYSTEM, INC.
Active
Other names
Independent Capacity System, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PASCAL THEBAUD (EXECUTIVE DIRECTOR)
(804) 721-1720
Entity
Organization
Contact information
Practice address
16015 CONTINENTAL BLVD, COLONIAL HEIGHTS, VA 23834-5900
(804) 721-1720
(804) 214-2177
Mailing address
PO BOX 3163, PETERSBURG, VA 23805-3163
(804) 721-1720
(804) 214-2177
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
VA
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
VA
Other
Enumeration date
03/15/2011
Last updated
03/15/2011
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