Liberty Square Care Center, LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

340777 Issued in IA

Legal business name

LIBERTY SQUARE CARE CENTER, LLC

Practice address

111 South Boulder
Nora Springs, IA 50458

Phone

(641) 792-5680

Fax

(641) 792-2630

NPI assigned

Apr 12, 2006

Last updated

Aug 22, 2020By 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

Michelle Zimbelman

Title

President

Phone

(816) 232-9573

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669436218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SOUTH BOULDER",
            "city": "NORA SPRINGS",
            "state": "IA",
            "postal_code": "50458",
            "telephone_number": "641-792-5680",
            "fax_number": "641-792-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SOUTH BOULDER",
            "city": "NORA SPRINGS",
            "state": "IA",
            "postal_code": "50458",
            "telephone_number": "641-792-5680",
            "fax_number": "641-792-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY SQUARE CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZIMBELMAN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-232-9573"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "IA",
            "license": "340777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0894063",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0232447",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0448449",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abcm Corporation (ABCM Healthy Living Home Care)
• Abcm Corporation (Nora Springs Care Center)
• Abcm Corporation
• Blake Carlton Ausenhus, PT, DPT
• Lisa M Kies, MD
• Shelley Ann Mosiman, RN BSN CCM DOLCM-CTR
• Nora Springs Ia Skilled Nursing Facility, LLC
• Nora Springs Ia Skilled Nursing Facility, LLC
• Nora Springs Ia Skilled Nursing Facility, LLC
• Nora Springs Rock Falls Community School District

• Custodial Care Facility in Nora Springs, IA
• Providers in Nora Springs, IA by specialty
• Custodial Care Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.