OrganizationActive
Icare Primary Care Clinic, LLC
NPI 1699173757 · Substance Abuse Rehabilitation Facility · Liberty, MO
Provider details
- NPI number
- 1699173757
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Erik Petersen, Chief Medical Officer(816) 875-4325
- License
- FL001411027 (MO)
Specialties & taxonomies
Residential Treatment Facilities
Practice location
550 Rush Creek Pkwy
Suite B
Liberty, MO 64068-9608
Phone: (816) 875-4325
Fax: (636) 237-8053
Approximate (ZIP-level) locationGet directions
Mailing address
550 Rush Creek Pkwy
Liberty, MO 64068-9608
Registry dates
- Enumerated
- 2014-12-05
- Last updated
- 2014-12-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.