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Organization

BLUE ICEBERG LLC

Active
Other names
Success on the Spectrum
Organization subpart
No

Provider details

NPI number
Authorized official
MR. STEVE YANG (CEO)
(651) 214-0197
Entity
Organization

Contact information

Practice address
8601 W CROSS DR UNIT B1, LITTLETON, CO 80123-2200
(651) 214-0197
Mailing address
8156 S WADSWORTH BLVD UNIT E-459, LITTLETON, CO 80128-9114
(651) 214-0197

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
261QH0700X
Hearing and Speech Clinic/Center
261QX0100X
Occupational Medicine Clinic/Center

Other

Enumeration date
11/07/2024
Last updated
11/07/2024
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