Liberty House

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

LIBERTY HOUSE

Practice address

1804 5TH St SE
Canton, OH 44707-3008

Phone

(330) 937-2316

NPI assigned

Sep 20, 2024

Organization subpart

No

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

Authorized official

Name

Ramah R Sistrunk

Title

Operator

Phone

(330) 937-2316

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1104643246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1387 GARMAN RD",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443136454",
            "telephone_number": "330-937-2316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 5TH ST SE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447073008",
            "telephone_number": "330-937-2316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "SISTRUNK",
        "authorized_official_first_name": "RAMAH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OPERATOR",
        "authorized_official_telephone_number": "330-937-2316"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Lewis, LPC
• Rachel Ann Lewis, CDCA
• Rebecca Lewis, LSW
• Ronald Stephen Lewis, RPH, MBA
• Tatyanah Lewis
• Jeremy Liebman, M.D.
• Teri Ann Lieser, CNS
• Life Bridge LLC
• Life Bridge Services
• Life Simplified, LLC

• Assisted Living Facility (Mental Illness) in Canton, OH
• Providers in Canton, OH by specialty
• Assisted Living Facility (Mental Illness) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.