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MAKING AN IMPACT LLC NPI 1023761673


NPI Information

NPI: 1023761673
Provider Name: MAKING AN IMPACT LLC

Doing Business As: ICARUS BEHAVIORAL HEALTH

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 32D2271388

Address:
5408 VERA CRUZ RD NE
RIO RANCHO, NM
ZIP 87144
Phone: (719) 651-7584
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MAKING AN IMPACT LLC is a substance abuse rehabilitation facility in Rio Rancho, NM. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. MAKING AN IMPACT LLC NPI is 1023761673. The provider is registered as an organization entity type.
The provider Is Doing Business As Icarus Behavioral Health.

The provider's business location address is:

5408 VERA CRUZ RD NE
RIO RANCHO, NM
ZIP 87144-281
Phone: (719) 651-7584

The provider's authorized official is Paul Covelli .
The authorized official title is Owner and has the following contact phone number (719) 651-7584.

The CLIA number assigned to this NPI record is 32D2271388 - other - behavioral health inpatie with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/2/2022 and was last updated on 12/8/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1324500000XSubstance Abuse Rehabilitation FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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