Healthcare Provider Details

I. General information

NPI: 1629204946
Provider Name (Legal Business Name): LIBERTY HEALTH CARE & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2009
Last Update Date: 06/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 HEREFORD RD
CLEVELAND OH
44112-3639
US

IV. Provider business mailing address

1111 HEREFORD RD
CLEVELAND OH
44112-3639
US

V. Phone/Fax

Practice location:
  • Phone: 216-397-7302
  • Fax:
Mailing address:
  • Phone: 216-397-7302
  • Fax:

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: DR. LEMUEL E. STEWART III
Title or Position: CEO
Credential: PSY.D.
Phone: 216-397-7302