Debora Liberty Healthcare Services LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

DEBORA LIBERTY HEALTHCARE SERVICES LLC

Doing business as

Liberty Health Care
Liberty Healthcare Services

Practice address

5701 Martin Luther King Jr Hwy # C
Capitol Heights, MD 20743-2156

Phone

(240) 481-6288

NPI assigned

Aug 13, 2021

Last updated

Mar 5, 2024By 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

Mr. Martin A. A Tinong, MIS

Title

President

Phone

(240) 481-6288

Specialties & licenses 1

Addresses

Other names 2

• LIBERTY HEALTH CARE Doing business as
• LIBERTY HEALTHCARE SERVICES Doing business as

Locations

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1306511043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 BLADENSBURG RD NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200181425",
            "telephone_number": "240-481-6288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 MARTIN LUTHER KING JR HWY # C",
            "city": "CAPITOL HEIGHTS",
            "state": "MD",
            "postal_code": "207432156",
            "telephone_number": "240-481-6288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORA LIBERTY HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-13",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "A TINONG",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-481-6288",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MIS"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIBERTY HEALTH CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LIBERTY HEALTHCARE SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Developmental Disabilities Clinic/Center in Capitol Heights, MD
• Providers in Capitol Heights, MD by specialty
• Developmental Disabilities Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.