Liberty/Matrix of Westwood LLC

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

License

520042 Issued in OH

Legal business name

LIBERTY/MATRIX OF WESTWOOD LLC

Practice address

7445 Liberty Woods LN
Dayton, OH 45459-3911

Phone

(937) 296-1550

Fax

(937) 296-1540

NPI assigned

Jun 10, 2006

Organization subpart

No

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

Authorized official

Name

Linda M Black-Kurek

Title

President

Phone

(937) 296-1550

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265473003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2171 HARRISON AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452118159",
            "telephone_number": "513-662-5800",
            "fax_number": "513-389-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY/MATRIX OF WESTWOOD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLACK-KUREK",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "M",
        "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": "520042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2561008",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ethan Libby
• Liberty Counseling and Consulting LLC
• Liberty Nursing Center of Bellbrook Inc
• Liberty Retirement Community of Washington Township, Inc.
• Liberty/Matrix of Oxford LLC
• Antonio M Licata, D.O.
• Grant Liebe, MD
• Janel Erin Lieber
• Margaret Liederbach, DO
• Brian Liepold

• Pediatric Skilled Nursing Facility in Dayton, OH
• Providers in Dayton, 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 Aug 22, 2020; 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.