| NPI | 1316779465 |
|---|---|
| Doing Business As | ICARUS BEHAVIORAL HEALTH NEVADA |
| Entity Type | Organization |
| Authorized Contact | PAUL COVELLI Owner 719-651-7584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-08-16 |
| Last Update Date | 2024-08-16 |