Healthcare Provider Details

I. General information

NPI: 1992660286
Provider Name (Legal Business Name): LIBERTY HOME CARE OF NEVADA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 E SUNRISE HWY
VALLEY STREAM NY
11581-1240
US

IV. Provider business mailing address

70 E SUNRISE HWY
VALLEY STREAM NY
11581-1240
US

V. Phone/Fax

Practice location:
  • Phone: 347-514-0512
  • Fax: 347-514-0512
Mailing address:
  • Phone: 347-514-0512
  • Fax: 347-514-0512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CHAVA LIPSETT
Title or Position: REGISTERED NURSE
Credential: RN
Phone: 347-514-0512