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General NPI Number Information
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NPI Number | 1023606589
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Entity Type | Organization
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Legal Business Name | LIBERTY MANOR
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Dates
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Enumeration Date | 01/08/2021
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Last Update Date | 01/15/2021
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Provider Practice Location Address
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Address Line | 9259 LIBERTY SCHOOL RD
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City | CAMBRIDGE
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State | OH
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Zip | 43725-9589
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Country | US
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Telephone | 740-432-0444
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Fax | 740-432-0491
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Provider Business Mailing Address
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Address Line | 9259 LIBERTY SCHOOL RD
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City | CAMBRIDGE
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State | OH
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Zip | 43725-9589
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Country | US
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Telephone | 740-432-0444
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Fax | 740-432-0491
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Authorized Official
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Title or Position | CASE MANGER/ CARE COORDINATOR
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Name | NANCY ANN WARD
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Credential |
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Telephone | 740-432-0444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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