| Intercept Youth Services, Inc. | |
|
5673 Airport Rd Roanoke VA 24012-1119 | |
| (804) 523-6202 | |
| Not Available |
| Full Name | Intercept Youth Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5673 Airport Rd, Roanoke, Virginia |
| Authorized Official Name and Position | Maria Elena Weaver (OFFICE MANAGER) |
| Authorized Official Contact | 5405238055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intercept Youth Services, Inc. 5511 Staples Mill Rd Ste 102 Richmond VA 23228-5445 Ph: () - | Intercept Youth Services, Inc. 5673 Airport Rd Roanoke VA 24012-1119 Ph: (804) 523-6202 |
| NPI Number | 1750096533 |
|---|---|
| Provider Enumeration Date | 01/17/2023 |
| Last Update Date | 01/17/2023 |
| Certification Date | 01/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750096533 | NPI | - | NPPES |
| 601028709 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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