National Provider Identifier Database

ICBM INC
Substance Abuse Disorder Rehabilitation Facility

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.


Contact Information

ICBM INC
1501 RED TAIL DR
ROCK SPRINGS, WY82901-5879
Phone: 307-362-6029
Fax: 307-362-2379
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X

* Indicates primary specialty

NPI Profile & details for ICBM INC

NPI Number 1205369576
Legal business name
LBN
ICBM INC
Authorized official ELINA CHERNYAK - (MEDICAL DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 04/04/2017
Last updated 04/04/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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