Healthcare Provider Details

I. General information

NPI: 1992309934
Provider Name (Legal Business Name): LIBERTY DAY CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7580 NORTHCLIFF AVE STE 500
BROOKLYN OH
44144-3272
US

IV. Provider business mailing address

35365 SPICEBUSH LN
SOLON OH
44139-5054
US

V. Phone/Fax

Practice location:
  • Phone: 216-862-8762
  • Fax:
Mailing address:
  • Phone: 440-476-9164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: SARAH STANTON
Title or Position: OWNER
Credential:
Phone: 440-476-9164