# ICARE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881190833
- **Authorized official:** SENTHIL K RAJU MD (PROVIDER)
- **Authorized official phone:** (405) 391-5526

## Contact information

- **Practice address:** 21001 SE 29TH ST UNIT 1, HARRAH, OK 73045-6577
- **Practice address phone:** (405) 391-5526
- **Practice address fax:** (405) 391-5529
- **Mailing address:** 21001 SE 29TH ST, HARRAH, OK 73045-6591

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/30/2018
- **Last updated:** 03/17/2022