NPIMap

Organization Active NPI

Loyd's Liberty Homes, Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Fresno, CA
National Provider Identifier
1366658726
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
0400378 Issued in CA
Legal business name
LOYD'S LIBERTY HOMES, INC
Practice address
6062 N Knoll Ave
Fresno, CA 93711-6512
Phone
(559) 451-0399
Fax
(559) 451-0141
NPI assigned
May 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Nancy Bargmann
Title
Vice President
Phone
(909) 579-3151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 0400378 CA Primary

Addresses

Primary practice location

6062 N Knoll Ave
Fresno, CA 93711-6512

Mailing address

3649 W Beechwood Ave
Ste 106
Fresno, CA 93711-0693
Phone (559) 451-0399

Other identifiers 1

IdentifierTypeStateIssuer
LTC60642FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 05G837

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
LOYD'S LIBERTY HOMES, INC-NORTH KNOLL
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jan 17, 1995
Last certification
Jan 24, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
6062 N Knoll Ave
Fresno, CA 93711

National Provider Directory

National Provider Directory
Tax ID family
Loyd's Liberty Homes Inc31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366658726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3649 W BEECHWOOD AVE",
            "address_2": "STE 106",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937110693",
            "telephone_number": "559-451-0399",
            "fax_number": "559-451-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6062 N KNOLL AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937116512",
            "telephone_number": "559-451-0399",
            "fax_number": "559-451-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOYD'S LIBERTY HOMES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARGMANN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "909-579-3151"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "0400378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60642F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.