Insurance Verification | Liberty Bay Recovery Center

Would you like to learn more about our rehab center and the services we offer? Contact Liberty Bay Recovery Center by filling out the form below. One of our admissions professionals will be in touch with you shortly, or call us at 855-607-8758.

Insurance Information
Primary Insured Name*
First Last
Primary Insured Date Of Birth*
MM
DD
YYYY
Primary Insured Address**
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Insurance Company's Name*
Insurance Company's Phone Number*
Member ID*
Group Number*
Subscriber relationship to client*
Person Seeking Treatment*
First Last
Date of Birth*
MM
DD
YYYY
Additional Information
Person of Contact's Name*
First Last
Person of Contact's Phone Number*
Person of Contact's Email*
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Insurance Information

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