Provider Demographics
NPI:1982985420
Name:INNER CIRCLE, INCORPORATED
Entity Type:Organization
Organization Name:INNER CIRCLE, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VALDIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:HANDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-644-3989
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:757-234-6979
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:757-234-6979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-29
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1693252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1205184413OtherNPI
VA1693OtherDEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES
VA1693OtherDEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES