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General NPI Number Information
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NPI Number | 1760719140
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Entity Type | Organization
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Legal Business Name | LIBERTY HEALTHCARE SERVICES
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Dates
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Enumeration Date | 11/05/2009
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Last Update Date | 11/05/2009
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Provider Practice Location Address
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Address Line | 495 BOULEVARD SUITE 1A
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City | ELMWOOD PARK
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State | NJ
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Zip | 07407-2041
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Country | US
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Telephone | 201-254-3076
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Fax |
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Provider Business Mailing Address
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Address Line | 495 BOULEVARD SUITE 1A
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City | ELMWOOD PARK
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State | NJ
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Zip | 07407-2041
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Country | US
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Telephone | 201-254-3076
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KEVIN R ZEPP
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Credential |
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Telephone | 609-890-0311
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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 | HP0103703
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License Number State | NJ
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