NPI | 1881402071 |
---|---|
Doing Business As | ICARUS BEHAVIORAL HEALTH IDAHO |
Entity Type | Organization |
Authorized Contact | BROOKE SGUARDO VP Of Program Integrity 480-299-2385 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2024-12-20 |
Last Update Date | 2025-02-07 |