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General NPI Number Information
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NPI Number | 1902108434
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Entity Type | Organization
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Legal Business Name | LIBERTY HOME HEALTH CARE INC
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Dates
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Enumeration Date | 12/05/2010
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Last Update Date | 12/05/2010
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Provider Practice Location Address
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Address Line | 4909 WATERS EDGE DR SUITE 216
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City | RALEIGH
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State | NC
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Zip | 27606-2462
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Country | US
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Telephone | 919-649-4858
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 58025
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City | RALEIGH
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State | NC
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Zip | 27658-8025
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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 | OWNER
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Name | UDE OLU
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Credential |
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Telephone | 919-649-4858
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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 | HC4205
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License Number State | NC
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