Organization · NPI-2

Icare Total Health Services, INC

Community/Behavioral Health · Peoria, AZ

NPI number1851973069

StatusActive

Last updated in NPPESAug 2, 2024

Details

NPI: 1851973069
Entity type: Organization (NPI-2)
Legal business name: Icare Total Health Services, INC
Organization subpart: Yes
Enumeration date: Apr 27, 2021
Certification date: Aug 2, 2024
Last updated: Aug 2, 2024

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
251S00000X	Community/Behavioral Health	–	–	Yes
103K00000X	Behavior Analyst	–	–
251B00000X	Case Management	–	–
251C00000X	Day Training, Developmentally Disabled Services	–	–
251E00000X	Home Health	–	–
253Z00000X	In Home Supportive Care	–	–
261QM0801X	Clinic/Center, Mental Health (Including Community Mental Health Center)	–	–
320800000X	Community Based Residential Treatment Facility, Mental Illness	–	–
343900000X	Non-emergency Medical Transport (VAN)	–	–

Other names

Mindfit 360 (Doing Business As)

Practice location

14050 N 83rd Ave Ste 290
Peoria, AZ 85381-5650

Phone 402-515-4874

Mailing address

14050 N 83rd Ave Ste 290
Peoria, AZ 85381-5650

Phone 402-515-4874

Authorized official

R Justice Braimah
President
4025154874

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.