INTERCEPT YOUTH SERVICES, INC. (NPI# 1679674329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679674329 |
| Entity Type | Organization |
| Organization Name | INTERCEPT YOUTH SERVICES, INC. |
| Other Organization Name | INDEPENDENCE HOUSE |
| Practice Address |
3111 N Parham Rd Richmond VA 23294-4408 |
| Mailing Address |
5511 Staples Mill Rd Suite 102 Richmond VA 23228-5445 |
| Practice Telephone | 8042707056 |
| Practice Fax Number | 8042707057 |
| Mailing Telephone | 8048641320 |
| Mailing Fax Number | 8048641323 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-09-24 |
| Authorized Official Name | DAVID RANDOLPH GRAHAM (DIR OF ACCOUNTING & ADMINISTRATION) |
| Authorized Official Telephone | 8048641320 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 295-14-003 | VA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 010075599 | 05 |
| Other Name | Type Code |
|---|---|
| Independence House | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598318107 | Intercept Youth Services, Inc. | Foster Care Agency | 307 W Main St Ste 102, Lebanon, VA 24266-4219 | 2019-07-23 |
| 1982264321 | Intercept Youth Services, Inc. | Foster Care Agency | 616 W Main St Ste A, Radford, VA 24141-1780 | 2019-06-18 |
| 1659931087 | Intercept Youth Services, Inc. | Foster Care Agency | 625 Piney Forest Rd Ste 105, Danville, VA 24540-2868 | 2019-06-18 |
| 1417514753 | Intercept Youth Services, Inc. | Foster Care Agency | 201 N Main St Ste 1101, Farmville, VA 23901-1300 | 2019-05-22 |
| 1609905678 | Intercept Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 4220 Courthouse Rd, Chesterfield, VA 23832-7210 | 2007-03-05 |
| 1265533566 | Intercept Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 11301 Lucks Ln, Midlothian, VA 23114-1218 | 2006-09-26 |
| 1942301312 | Intercept Youth Services, Inc. | Community/Behavioral Health | 1700 Turner Rd, Richmond, VA 23225-6941 | 2006-09-26 |
| 1427159094 | Intercept Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 605 Calvert St, Staunton, VA 24401-4754 | 2006-09-26 |
| 1023119484 | Intercept Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 3117 Skipwith Rd, Richmond, VA 23294-4133 | 2006-09-26 |
| 1407957822 | Intercept Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 11622 Warwick Blvd, Newport News, VA 23601-2345 | 2006-09-26 |
| Street Address |
3111 N PARHAM RD |
| City | RICHMOND |
| State | VA |
| Zip Code | 23294-4408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316221948 | David Sorrentino | Counselor | 3111 N Parham Rd, Richmond, VA 23294-4408 | 2011-09-30 |
| 1205910908 | Leeann Lane | Social Worker | 3111 N Parham Rd, Richmond, VA 23294-4408 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811454994 | Joshua Fritz | Behavior Technician | 2601 Willard Rd, Ste 105, Richmond, VA 23294 | 2019-02-26 |
| 1578020608 | Nicole Hoppe | Behavior Technician | 2601 Willard Road, Ste 105, Richmond, VA 23294 | 2019-02-25 |
| 1699278713 | Osman Med Transportation LLC | Non-emergency Medical Transport (VAN) | 8703 Queensmere Plz Apt 2, Henrico, VA 23294 | 2018-03-15 |
| 1346742830 | F.c. of Virginia, Inc. | Hospice Care, Community Based | 8401 Mayland Drive Suite L, Richmond, VA 23294 | 2018-03-01 |
| 1497256911 | Susan Marie Robinson | Speech-Language Pathologist | 9200 Mapleview Avenue, Richmond, VA 23294 | 2018-02-21 |
| 1407375512 | Lisa Therese Hall | Speech-Language Pathologist | Skipwith Elementary School, 2401 Skipwith Rd., Henrico, VA 23294 | 2017-09-11 |
| 1295257863 | All Around Taxi Service.inc | Taxi | 8601 Pellington Pl #7, Richmond, VA 23294 | 2017-07-14 |
| 1992225809 | Pony-care Transportation, Inc | Non-emergency Medical Transport (VAN) | 3212 Skipwith Road, Suite L3, Henrico, VA 23294 | 2017-06-21 |
| 1801325295 | Christina Chaney | Behavior Technician | 9351 West Broad St, Henrico, VA 23294 | 2017-06-08 |
| 1033648423 | Sarah Jennings | Behavior Technician | 9351 West Broad St., Henrico, VA 23294 | 2017-06-08 |
| Find all providers in zip 23294 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063030054 | Life's Purpose | Residential Treatment Facility, Emotionally Disturbed Children | 1211 Lark Ln, Richmond, TX 77469-7803 | 2020-07-07 |
| 1871099721 | Imagination LLC | Residential Treatment Facility, Emotionally Disturbed Children | 318 N Wilkinson Rd, Richmond, VA 23227-1631 | 2018-03-31 |
| 1336454552 | Wernle Youth & Family Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 2000 Wernle Rd, Richmond, IN 47374-7015 | 2010-08-12 |
| 1053641167 | Postive Outlook | Residential Treatment Facility, Emotionally Disturbed Children | 3601 Springtime Ct, Richmond, VA 23223-1692 | 2010-01-12 |
| 1568698165 | Hopes Haven Inc | Residential Treatment Facility, Emotionally Disturbed Children | 3515 Skipping Rock Way, Richmond, VA 23234-2971 | 2009-06-09 |
| 1356593693 | Jackson-feild Homes | Residential Treatment Facility, Emotionally Disturbed Children | 205 North Blvd, Richmond, VA 23220-4006 | 2008-10-17 |
| 1952567182 | Secure Haven Youth Services | Residential Treatment Facility, Emotionally Disturbed Children | 1706 Hungary Rd, Richmond, VA 23228-2335 | 2008-08-07 |
| 1134389943 | Gabrielle's House | Residential Treatment Facility, Emotionally Disturbed Children | 725 S Providence Rd, Richmond, VA 23236-3337 | 2008-06-15 |
| 1669649364 | Strong Girls, Smart Women LLC | Residential Treatment Facility, Emotionally Disturbed Children | 5210 Lingle Ln, Richmond, VA 23234-6618 | 2008-05-12 |
| 1225200827 | Back 2 Basics, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3808 Candlegrove Ct, Richmond, VA 23223-1440 | 2008-03-24 |
| Find all providers in RICHMOND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.