Organization Active NPI

Liberty House Recovery Center LLC

  • Substance Abuse Rehabilitation Facility
  • Fenton, MI
National Provider Identifier
1619565173
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
LIBERTY HOUSE RECOVERY CENTER LLC
Practice address
13520 White Lake Rd
Fenton, MI 48430-8428
Phone
(810) 208-0266
Fax
(810) 936-8228
NPI assigned
Jan 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Authorized official

Name
Dr. Susan Abed, DDS-MSNPI 1780854455
Title
Ceo
Phone
(810) 208-0266

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

13520 White Lake Rd
Fenton, MI 48430-8428

Mailing address

13520 White Lake Rd
Fenton, MI 48430-8428

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2262979Liberty House Recovery Center13520 White Lake Road, Fenton, MI 48430Certificate of waiverJun 20, 2028

National Provider Directory

National Provider Directory

Locations

13520 White Lake Rd
Fenton, MI 48430
Phone (810) 208-0266

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1610150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1619565173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13520 WHITE LAKE RD",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484308428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13520 WHITE LAKE RD",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484308428",
            "telephone_number": "810-208-0266",
            "fax_number": "810-936-8228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HOUSE RECOVERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-09",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "ABED",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "810-208-0266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS-MS"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.