| Icare Health Services LLC | |
|
4272 E Cane Ranch Rd Kingman AZ 86401 | |
| (202) 717-2541 | |
| Not Available |
| Full Name | Icare Health Services LLC |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
| Location | 4272 E Cane Ranch Rd, Kingman, Arizona |
| Authorized Official Name and Position | Victoria Fabuluje (PRESIDENT/CEO) |
| Authorized Official Contact | 2027172541 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Icare Health Services LLC 10851 N Black Canyon Hwy Ste 700 Phoenix AZ 85029-4788 Ph: (202) 717-2541 | Icare Health Services LLC 4272 E Cane Ranch Rd Kingman AZ 86401 Ph: (202) 717-2541 |
| NPI Number | 1710789706 |
|---|---|
| Provider Enumeration Date | 03/27/2025 |
| Last Update Date | 03/27/2025 |
| Certification Date | 03/25/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710789706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | () | Secondary |
| 320900000X | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities | () | Primary |
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