MEDICARE: LIBERTY HEALTH CARE & ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1629204946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIBERTY HEALTH CARE & ASSOCIATES

Provider Business Mailing Address
First Line	:	1111 HEREFORD RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44112-3639
Country	:	US
Telephone Number	:	216-397-7302
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 HEREFORD RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44112-3639
Country	:	US
Telephone Number	:	216-397-7302
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. LEMUEL E. STEWART III
Credential	:	PSY.D.
Telephone Number	:	216-397-7302

Provider Enumeration Date	:	06/01/2009
Last Update Date	:	06/01/2009

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