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General NPI Number Information
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NPI Number | 1568225092
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Entity Type | Organization
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Legal Business Name | WOODLANDS OF LIBERTY LLC
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Dates
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Enumeration Date | 02/06/2024
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 1054 FREEDOM DR
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City | WADSWORTH
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State | OH
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Zip | 44281-8255
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Country | US
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Telephone | 330-334-3262
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Fax | 330-334-3323
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Provider Business Mailing Address
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Address Line | 1054 FREEDOM DR
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City | WADSWORTH
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State | OH
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Zip | 44281-8255
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Country | US
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Telephone | 330-334-3262
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Fax | 330-334-3323
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Authorized Official
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Title or Position | ASSISTANT
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Name | SHERRI BERGHOFF
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Credential |
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Telephone | 260-740-3220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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