Liberty Health Care, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

342610 Issued in MN

Legal business name

LIBERTY HEALTH CARE, INC

Practice address

4106 71St Ave N
Brooklyn Center, MN 55429-1305

Phone

(763) 670-5614

Fax

(763) 503-4824

NPI assigned

Feb 9, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Aamfoulth Davies

Title

President

Phone

(763) 670-5614

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234137600000",
    "number": "1245479690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4106 71ST AVE N",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554291305",
            "telephone_number": "763-670-5614",
            "fax_number": "763-503-4824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4106 71ST AVE N",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554291305",
            "telephone_number": "763-670-5614",
            "fax_number": "763-503-4824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HEALTH CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-09",
        "last_updated": "2009-02-09",
        "status": "A",
        "authorized_official_last_name": "DAVIES",
        "authorized_official_first_name": "AAMFOULTH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-670-5614",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "342610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMPI",
            "identifier": "A642680000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Brooklyn Center, MN
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• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2009; 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.