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INTERCEPT SHIRE HOUSE NPI 1447454509


NPI Information

NPI: 1447454509
Provider Name: INTERCEPT SHIRE HOUSE

Other Name: SHIRE HOUSE

Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
12016 EDENSHIRE RD
CHESTER, VA
ZIP 23831
Phone: (804) 706-1463
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INTERCEPT SHIRE HOUSE is a residential treatment facility emotionally disturbed children in Chester, VA. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. INTERCEPT SHIRE HOUSE NPI is 1447454509. The provider is registered as an organization entity type.
The provider Other Name Is Shire House.

The provider's business location address is:

12016 EDENSHIRE RD
CHESTER, VA
ZIP 23831-723
Phone: (804) 706-1463
Fax: (804) 706-1465

The provider's authorized official is David Randolph Graham .
The authorized official title is Dir Of Finance & Admin and has the following contact phone number (804) 864-1320.

The enumeration date for this NPI number is 6/13/2007 and was last updated on 9/24/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1322D00000XResidential Treatment Facility, Emotionally Disturbed Children295-14-016VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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