Liberty Lodge, Inc.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

LIBERTY LODGE, INC.

Practice address

160 FM 2507
Alice, TX 78332-7763

Phone

(361) 664-7555

NPI assigned

Mar 3, 2020

Last updated

Jan 24, 2023By 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

Rhonda PatrickNPI 1366718157

Title

Director

Phone

(713) 397-9098

Specialties & licenses 2

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rhonda Genae Patrick, LCSW-S, PHD

  • Clinical Social Worker
  • Round Rock, TX
  • NPI 1366718157
  Authorized official Same address or phone

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674518400000",
    "number": "1376178053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3915",
            "city": "ALICE",
            "state": "TX",
            "postal_code": "783333915",
            "telephone_number": "361-664-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 FM 2507",
            "city": "ALICE",
            "state": "TX",
            "postal_code": "783327763",
            "telephone_number": "361-664-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY LODGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-03",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "PATRICK",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "713-397-9098"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "libertylodge.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "160 Fm 2507",
            "city": "Alice",
            "state": "TX",
            "country_code": "US",
            "postal_code": "783327763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Alice, TX
• Providers in Alice, TX by specialty
• Substance Abuse Rehabilitation Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.