Provider Demographics
NPI:1205184413
Name:INNER CIRCLE, INCORPORATED
Entity Type:Organization
Organization Name:INNER CIRCLE, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VALDIMIR
Authorized Official - Middle Name:DEMONT
Authorized Official - Last Name:HANDY
Authorized Official - Suffix:
Authorized Official - Credentials:CSAC
Authorized Official - Phone:757-818-3341
Mailing Address - Street 1:2204 EXECUTIVE DR STE A
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-6602
Mailing Address - Country:US
Mailing Address - Phone:757-644-3989
Mailing Address - Fax:
Practice Address - Street 1:2204 EXECUTIVE DR STE A
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-6602
Practice Address - Country:US
Practice Address - Phone:757-644-3989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-17
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1693251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health