Liberty Nursing Center of Willard Inc

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

License

6015 Issued in OH

Legal business name

LIBERTY NURSING CENTER OF WILLARD INC

Doing business as

Hillside Acres

Practice address

370 E Howard St
Willard, OH 44890-1656

Phone

(419) 935-0148

Fax

(419) 933-6448

NPI assigned

Jul 1, 2006

Last updated

Dec 17, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Linda Black-Kurek

Title

President

Phone

(937) 296-1550

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hillside Acres Doing business as

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387238400000",
    "number": "1093744104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7445 LIBERTY WOODS LN",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454593911",
            "telephone_number": "937-296-1550",
            "fax_number": "937-296-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 E HOWARD ST",
            "city": "WILLARD",
            "state": "OH",
            "postal_code": "448901656",
            "telephone_number": "419-935-0148",
            "fax_number": "419-933-6448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY NURSING CENTER OF WILLARD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2013-12-17",
        "status": "A",
        "authorized_official_last_name": "BLACK-KUREK",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-296-1550"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "OH",
            "license": "6015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2245010",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillside Acres",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chelsea Kreuter, PMHNP-BC
• Eric Kuivinen, M.D.
• Carley Suzanne Lambert, QMHS
• Landmark Recovery of Ohio LLC
• Amelia L Layne
• Liberty Nursing Center Willard (Hillside Acres)
• Donn Robert Lidington, DDS
• Cassandra Marie Link, OTR/L
• Brian A. Lynch, PA-C
• Sarah Madrid

• Pediatric Skilled Nursing Facility in Willard, OH
• Providers in Willard, OH by specialty
• Pediatric Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.