Healthcare Provider Details

I. General information

NPI: 1184510406
Provider Name (Legal Business Name): LIBERTY CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2025
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5325 W 74TH ST STE 9
EDINA MN
55439-2212
US

IV. Provider business mailing address

5325 W 74TH ST STE 9
EDINA MN
55439-2212
US

V. Phone/Fax

Practice location:
  • Phone: 952-657-9674
  • Fax: 952-487-5063
Mailing address:
  • Phone: 952-657-9674
  • Fax: 952-487-5063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LIBERTY CARE SERVICES
Title or Position: DIRECTOR
Credential:
Phone: 952-657-9674