MEDICARE: ICARE THERAPY OH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1538050380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ICARE THERAPY OH LLC

Provider Business Mailing Address
First Line	:	825 W END AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-5349
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2375 S BELVOIR BLVD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-4652
Country	:	US
Telephone Number	:	303-954-9446
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ALEXANDER DENCIGER
Credential	:
Telephone Number	:	800-264-1985

Provider Enumeration Date	:	07/10/2025
Last Update Date	:	12/19/2025

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