MEDICARE: INTERCEPT YOUTH SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253J00000X	Foster Care Agency	CO-293-09	VA

General Provider Information

NPI Number	:	1932334000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERCEPT YOUTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	5511 STAPLES MILL RD
Second Line	:	SUITE 102
City	:	RICHMOND
State	:	VA
Zip	:	23228-5445
Country	:	US
Telephone Number	:	804-864-1320
Fax Number	:	804-864-1323

Provider Business Practice Location Address
First Line	:	5673 AIRPORT RD
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24012-1119
Country	:	US
Telephone Number	:	804-440-3700
Fax Number	:

Authorized Official
Title or Position	:	REVENUE CYCLE MANAGER
Name	:	YOLANDA WINFIELD
Credential	:
Telephone Number	:	804-807-1201

Provider Enumeration Date	:	05/19/2009
Last Update Date	:	07/03/2025

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