Independent Capacity System, Inc. | |
16015 Continental Blvd Colonial Heights VA 23834-5900 | |
(804) 721-1720 | |
(804) 214-2177 |
Full Name | Independent Capacity System, Inc. |
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Speciality | Community/behavioral Health |
Location | 16015 Continental Blvd, Colonial Heights, Virginia |
Authorized Official Name and Position | Pascal Thebaud (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 8047211720 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Independent Capacity System, Inc. Po Box 3163 Petersburg VA 23805-3163 Ph: (804) 721-1720 | Independent Capacity System, Inc. 16015 Continental Blvd Colonial Heights VA 23834-5900 Ph: (804) 721-1720 |
NPI Number | 1790084804 |
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Provider Enumeration Date | 03/15/2011 |
Last Update Date | 03/15/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790084804 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (Virginia) | Primary |
320600000X | Residential Treatment Facility, Intellectual And/or Developmental Disabilities | (Virginia) | Secondary |
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