Liberty Island Personal Care Home

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

00080900 Issued in TX

Legal business name

LIBERTY ISLAND PERSONAL CARE HOME

Practice address

9009 Boone Rd
Houston, TX 77099-2033

Phone

(281) 530-0000

Fax

(281) 530-3735

NPI assigned

Mar 15, 2008

Last updated

Mar 15, 2008By 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. Charles Edward Johnson

Title

Director of Operations

Phone

(281) 530-0000

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1205539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205539200000",
    "number": "1336310556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9009 BOONE RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770992033",
            "telephone_number": "281-530-0000",
            "fax_number": "281-530-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9009 BOONE RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770992033",
            "telephone_number": "281-530-0000",
            "fax_number": "281-530-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY ISLAND PERSONAL CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-15",
        "last_updated": "2008-03-15",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "281-530-0000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "TX",
            "license": "00080900",
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "TX",
            "license": "00098700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CARE HOME",
            "identifier": "00080900",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CARE HOME",
            "identifier": "00098700",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liberty Foot & Ankle Surgery Center, PA
• Liberty Health System LLC
• Liberty Health System LLC
• Liberty International Inc (Liberty EMS)
• Liberty Island Adult Day Care
• Libnig Group of Companies LLC
• Libra Hospice Inc.
• Julia M. Libreros, PTA
• Alma L. Librojo, RN, NP-C
• Tamara Felicia Liburd

• Mental Illness Community Based Residential Treatment Facility in Houston, TX
• Providers in Houston, TX by specialty
• Mental Illness Community Based Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2008; 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.