Organization
ICARUS HOUSE LLC.
Active
Organization
ICARUS HOUSE LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONATUS AGBAKWU (CEO/MANGER)
(310) 621-2776
Entity
Organization
Contact information
Practice address
23832 W TONTO ST, BUCKEYE, AZ 85326-8139
(310) 621-2776
Mailing address
1721 W MAGDALENA LN, PHOENIX, AZ 85041-7814
(310) 621-2776
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/21/2024
Last updated
02/21/2024
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