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General NPI Number Information
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NPI Number | 1568705317
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Entity Type | Organization
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Legal Business Name | LIBERTY HOUSING SERVICES INC.
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Dates
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Enumeration Date | 03/30/2013
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Last Update Date | 03/30/2013
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Provider Practice Location Address
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Address Line | 906 DORMAN ST
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City | SANTA ANA
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State | CA
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Zip | 92701-2523
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Country | US
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Telephone | 714-486-3691
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Fax |
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Provider Business Mailing Address
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Address Line | 17602 17TH ST STE 102-123
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City | TUSTIN
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State | CA
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Zip | 92780-1961
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MAY ABDELNABY
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Credential |
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Telephone | 714-883-3133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 300249AP
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License Number State | CA
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