Organization
ICARE HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA FABULUJE (PRESIDENT/CEO)
(202) 717-2541
Entity
Organization
Contact information
Practice address
4272 E CANE RANCH RD, KINGMAN, AZ 86401
(202) 717-2541
Mailing address
10851 N BLACK CANYON HWY STE 700, PHOENIX, AZ 85029-4788
(202) 717-2541
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/27/2025
Last updated
03/27/2025
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