Healthcare Provider Details

I. General information

NPI: 1982845830
Provider Name (Legal Business Name): LIBERTY COMMUNITY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2009
Last Update Date: 09/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7002 W BUTLER PIKE
AMBLER PA
19002-5107
US

IV. Provider business mailing address

7002 W BUTLER PIKE
AMBLER PA
19002-5107
US

V. Phone/Fax

Practice location:
  • Phone: 267-464-7745
  • Fax: 215-464-7755
Mailing address:
  • Phone: 267-464-7745
  • Fax: 215-464-7755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberAPPLIED FOR
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number17631601
License Number StatePA

VIII. Authorized Official

Name: MR. JOHN M. BARNUM
Title or Position: CHIEF FINANCIAL OFFICER
Credential: NHA
Phone: 215-464-7745