Liberty Community Programs WV

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

LIBERTY COMMUNITY PROGRAMS WV

Practice address

133 Hedrick Dr
Sugar Grove, WV 26815-5068

Phone

(925) 518-1340

NPI assigned

Jun 6, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Fredericka Ford, MA, MBE

Title

Coo

Phone

(925) 518-1340

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kendall Jackson

  • Substance Abuse Rehabilitation Facility
  • Sugar Grove, WV
  • NPI 1184557456
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1780704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780704000000",
    "number": "1053244293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 HEDRICK DR",
            "city": "SUGAR GROVE",
            "state": "WV",
            "postal_code": "268155068",
            "telephone_number": "925-518-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 HEDRICK DR",
            "city": "SUGAR GROVE",
            "state": "WV",
            "postal_code": "268155068",
            "telephone_number": "925-518-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY COMMUNITY PROGRAMS WV",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-06",
        "last_updated": "2026-06-06",
        "certification_date": "2026-06-06",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "FREDERICKA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "925-518-1340",
        "authorized_official_credential": "MA, MBE"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tai Deavers
• Jessica Eckard
• Kendall Jackson
• Daniel Johnson
• Ashley Lambert
• Naval Information Operations
• Brenda Propst
• Nancy Pultz
• Ivory Rader
• Patricia A. Rexrode

• Substance Abuse Rehabilitation Facility in Sugar Grove, WV
• Providers in Sugar Grove, WV by specialty
• Substance Abuse Rehabilitation Facility in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.