Healthcare Provider Details

I. General information

NPI: 1427834670
Provider Name (Legal Business Name): INTERCEPT YOUTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2023
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3117 SKIPWITH RD
RICHMOND VA
23294-4133
US

IV. Provider business mailing address

5511 STAPLES MILL RD STE 102
HENRICO VA
23228-5445
US

V. Phone/Fax

Practice location:
  • Phone: 804-440-3700
  • Fax:
Mailing address:
  • Phone: 804-440-3700
  • Fax: 804-264-2451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: YOLANDA WINFIELD
Title or Position: REVEUE CYCLE MANAGER
Credential:
Phone: 804-807-1201