Provider Demographics
NPI:1447121850
Name:INCLUSIVE CHILDREN CARE LLC,
Entity type:Organization
Organization Name:INCLUSIVE CHILDREN CARE LLC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EYTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-214-7716
Mailing Address - Street 1:2807 N PARHAM RD STE 320
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4458
Mailing Address - Country:US
Mailing Address - Phone:804-214-7716
Mailing Address - Fax:
Practice Address - Street 1:1217 DARREN DR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23701-3730
Practice Address - Country:US
Practice Address - Phone:804-214-7716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities