| Independent Capacity System, Inc. | |
|
16015 Continental Blvd Colonial Heights VA 23834-5900 | |
| (804) 721-1720 | |
| (804) 214-2177 |
| Full Name | Independent Capacity System, Inc. |
|---|---|
| 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 |
|---|---|
| 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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