Liberty Retirement Community of Washington Township, Inc.

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

License

6400 Issued in OH

Legal business name

LIBERTY RETIREMENT COMMUNITY OF WASHINGTON TOWNSHIP, INC.

Practice address

7300 McEwen Rd
Dayton, OH 45459-3903

Phone

(937) 433-3441

Fax

(937) 433-6207

NPI assigned

Jul 1, 2006

Last updated

Oct 31, 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

Linda 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": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225411200000",
    "number": "1407885536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 MCEWEN RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454593903",
            "telephone_number": "937-433-3441",
            "fax_number": "937-433-6207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY RETIREMENT COMMUNITY OF WASHINGTON TOWNSHIP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2008-10-31",
        "status": "A",
        "authorized_official_last_name": "BLACK-KUREK",
        "authorized_official_first_name": "LINDA",
        "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": "6400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2335146",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Xinwei Li
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• Ethan Libby
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• Liberty Nursing Center of Bellbrook Inc
• Liberty/Matrix of Oxford LLC
• Liberty/Matrix of Westwood LLC
• Antonio M Licata, D.O.
• Grant Liebe, MD
• Janel Erin Lieber

• 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 Oct 31, 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.