Healthcare Provider Details

I. General information

NPI: 1528878402
Provider Name (Legal Business Name): LEBARTY IN-HOME AND COMMUNITY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 01/13/2025
Certification Date: 01/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1662 CENTRAL AVE
COLONIE NY
12205-4059
US

IV. Provider business mailing address

1662 CENTRAL AVE
COLONIE NY
12205-4059
US

V. Phone/Fax

Practice location:
  • Phone: 518-951-0740
  • Fax: 607-800-4134
Mailing address:
  • Phone: 518-951-0740
  • Fax: 607-800-4134

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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. NOSA DENNIS AIGBE LEBARTY
Title or Position: OWNER
Credential: MD
Phone: 518-951-0740