| NPI | 1316344658 |
|---|---|
| Other Name | ICARE ADDICTION CLINIC |
| Entity Type | Organization |
| Authorized Contact | JENNIFER PETERSEN Office Manager 816-875-4325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MO 20110330076) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2014-12-02 |