Liberty Provider LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

LIBERTY PROVIDER LLC

Practice address

7110 W Central Ave Ste a
Toledo, OH 43617-3118

Phone

(419) 517-7000

NPI assigned

Dec 28, 2018

Organization subpart

No

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

Authorized official

Name

William Timothy Bruck

Title

Owner

Phone

(734) 344-7331

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1545955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545955200000",
    "number": "1508338708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7110 W CENTRAL AVE STE A",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436173118",
            "telephone_number": "419-517-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7110 W CENTRAL AVE STE A",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436173118",
            "telephone_number": "419-517-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY PROVIDER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-28",
        "last_updated": "2018-12-28",
        "status": "A",
        "authorized_official_last_name": "BRUCK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-344-7331"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zhehan Li, D.D.S
• Nicholas Liaw, MD
• Lynn Brookfield Liber, MNT
• Liberty Group Foundation, LLC
• Liberty Nursing Center of Toledo, Inc
• Liberty West Nursing Center of Toledo Inc
• Brandon Licht, MD
• Paige Lichtenberg
• Safiya Liddell-Smith
• Rebecca Liebes

• Home Health Agency in Toledo, OH
• Providers in Toledo, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.