Liberty Club Seniors Inc

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

LIBERTY CLUB SENIORS INC

Practice address

10329 Cross Creek Blvd
Suite P
Tampa, FL 33647-2994

Phone

(813) 991-1960

Fax

(813) 991-1961

NPI assigned

Jan 12, 2007

Last updated

Dec 12, 2007By 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

Ethel Catlin, MSW-ACSW

Title

Chief Administrator

Phone

(813) 991-1960

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1225188923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10329 CROSS CREEK BLVD",
            "address_2": "SUITE P",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472994",
            "telephone_number": "813-991-1960",
            "fax_number": "813-991-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10329 CROSS CREEK BLVD",
            "address_2": "SUITE P",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472994",
            "telephone_number": "813-991-1960",
            "fax_number": "813-991-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY CLUB SENIORS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "CATLIN",
        "authorized_official_first_name": "ETHEL",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATOR",
        "authorized_official_telephone_number": "813-991-1960",
        "authorized_official_credential": "MSW-ACSW"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Neil Liao
• A'Jiah Joah Lias
• Peter Vincent Libero, M.D.
• Adelina Liberto, LCSW
• Liberty Assisted Living (Central Tampa Assisted Living)
• Liberty Dental Plan of Florida, Inc.
• Liberty Dental Plan of Florida, Inc.
• Liberty Dental Plan of Florida, Inc.
• Liberty Dental Plan of Florida, Inc.
• Liberty Dental Plan of Florida, Inc.

• Adult Day Care Clinic/Center in Tampa, FL
• Providers in Tampa, FL by specialty
• Adult Day Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.