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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