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General NPI Number Information
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NPI Number | 1881129609
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Entity Type | Organization
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Legal Business Name | LIBERTY PARTNER LLC
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Dates
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Enumeration Date | 04/30/2017
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Last Update Date | 04/30/2017
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Provider Practice Location Address
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Address Line | 235 N MAIN ST
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City | ADRIAN
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State | MI
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Zip | 49221-2712
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Country | US
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Telephone | 517-920-4254
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Fax | 888-306-0434
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Provider Business Mailing Address
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Address Line | 235 N MAIN ST
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City | ADRIAN
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State | MI
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Zip | 49221-2712
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Country | US
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Telephone | 517-920-4254
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Fax | 888-306-0434
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Authorized Official
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Title or Position | OWNER / DIRECTOR
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Name | MR. TIMOTHY SCOTT WELBAUM JR.
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Credential |
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Telephone | 616-719-7358
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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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