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General NPI Number Information
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NPI Number | 1356607832
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Entity Type | Organization
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Legal Business Name | INTERCEPT YOUTH SERVICES, INC.
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Dates
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Enumeration Date | 04/09/2012
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 10187 BROOK RD
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City | GLEN ALLEN
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State | VA
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Zip | 23059-6508
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Country | US
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Telephone | 540-315-6659
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Fax |
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Provider Business Mailing Address
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Address Line | 5511 STAPLES MILL RD STE 102
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City | RICHMOND
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State | VA
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Zip | 23228-5445
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REVENUE CYCLE MANAGER
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Name | YOLANDA WINFIELD
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Credential |
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Telephone | 804-807-1201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 295-05-001
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License Number State | VA
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