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General NPI Number Information
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NPI Number | 1063226835
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Entity Type | Organization
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Legal Business Name | LIBERTY SENIOR CARE SERVICES
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 5714 N 50TH ST
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City | OMAHA
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State | NE
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Zip | 68104-1325
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Country | US
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Telephone | 531-228-1888
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Fax |
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Provider Business Mailing Address
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Address Line | 5714 N 50TH ST
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City | OMAHA
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State | NE
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Zip | 68104-1325
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Country | US
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Telephone | 531-228-1888
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANI LATECE CULLUM
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Credential | TIFFANI CULLUM
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Telephone | 531-228-1888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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