Icare Addiction Clinic

LBN: Icare Primary Care
Icare Addiction Clinic is an health care organization with primary practice located at 550 Rush Creek Pkwy Suite B, Liberty MO 64068-9608. The organization recently has only one registered license in Managed Care Organizations / Exclusive Provider Organization, which is considered as the primary health care specialty. Icare Primary Care can be contacted via phone (816) 875-4325, or through Petersen, Jennifer via phone (816) 875-4325.

Contact Information

Primary practice address
550 Rush Creek Pkwy Suite B Liberty MO 64068-9608
Phone: (816) 875-4325
Fax: (816) 407-9809
Website:
Map and Directions
Authorized official contact:
Name: Petersen, Jennifer
Phone: (816) 875-4325

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Exclusive Provider Organization 302F00000X 20110330076 Missouri

Profile Details

NPI number 1316344658
LBN Legal business name Icare Primary Care
DBA Doing business as Icare Addiction Clinic
Authorized official Petersen, Jennifer
Entity Organization
Organization subpart 1 No
Enumeration date Dec 2nd, 2014
Last updated Dec 2nd, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316344658 NPPES
Other 1699716910 PHYSICIAN

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