MAKING AN IMPACT LLC NPI 1023761673

NPI Information

  • NPI: 1023761673
  • Provider Name: MAKING AN IMPACT LLC
  • Classification: Substance Abuse Rehabilitation Facility - 324500000X
  • Entity Type: Organization
  • Doing Business As: ICARUS BEHAVIORAL HEALTH
  • CLIA Number: 32D2271386
  • Address: 5408 VERA CRUZ RD NE
    RIO RANCHO, NM
    ZIP 87144
  • Phone: (719) 651-7584

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NPI Details

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 32D2271386 - 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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1324500000XSubstance Abuse Rehabilitation FacilityYes

What is NPI?

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This page was last updated on: 11/21/2025

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