NPIMap

Organization Active NPI

Liberty House LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Wellington, FL
National Provider Identifier
1104295583
Registry record updated Sep 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
10D2099701 Issued in FL
Legal business name
LIBERTY HOUSE LLC
Practice address
9314 Forest Hill Blvd
313
Wellington, FL 33411-6577
Phone
(561) 460-4137
NPI assigned
Sep 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2015

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

Authorized official

Name
Henry Pal Regan
Title
Ceo
Phone
(561) 460-4137

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 10D2099701 FL Primary

Addresses

Primary practice location

9314 Forest Hill Blvd
313
Wellington, FL 33411-6577

Mailing address

9314 Forest Hill Blvd
313
Wellington, FL 33411-6577

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1104295583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9314 FOREST HILL BLVD",
            "address_2": "313",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334116577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9314 FOREST HILL BLVD",
            "address_2": "313",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334116577",
            "telephone_number": "561-460-4137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-16",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "REGAN",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "PAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-460-4137"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "FL",
            "license": "10D2099701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; 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.