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Organization

INNER CIRCLE, INCORPORATED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VALDIMIR HANDY (CEO)
(757) 644-3989
Entity
Organization

Contact information

Practice address
2204 EXECUTIVE DR STE A, HAMPTON, VA 23666-6602
(757) 644-3989
(757) 234-6979
Mailing address
2204 EXECUTIVE DR STE A, HAMPTON, VA 23666-6602
(757) 644-3989
(757) 234-6979

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1693
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1205184413
NPI
VA
01
1693
DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES
VA
Enumeration date
08/29/2011
Last updated
05/12/2016
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