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General NPI Number Information
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NPI Number | 1861565517
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Entity Type | Organization
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Legal Business Name | LIBERTY HOUSE
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1133 N LIBERTY LANE
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City | ANAHEIM
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State | CA
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Zip | 92805
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Country | US
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Telephone | 714-535-2943
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Fax | 714-956-7303
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Provider Business Mailing Address
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Address Line | 15331 NORMANDY LANE
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City | LAMIRANDA
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State | CA
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Zip | 90638
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Country | US
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Telephone | 714-535-2943
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Fax | 714-956-7303
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MAGGIE S FRANI
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Credential |
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Telephone | 714-213-5009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number |
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License Number State |
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