NPIMap

Organization Active NPI

Liberty Manor Residency, Inc.

  • Assisted Living Facility (Mental Illness)
  • Phoenix, AZ
National Provider Identifier
1720174303
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
License
ALH-4580 Issued in AZ
Legal business name
LIBERTY MANOR RESIDENCY, INC.
Practice address
17632 N 5TH PL
Phoenix, AZ 85022-1809
Phone
(602) 441-2563
Fax
(602) 354-7129
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Maria Roxas, LPN
Title
President
Phone
(602) 524-8124

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X ALH-4580 AZ
Assisted Living Facility (Mental Illness) 3104A0625X ALH-4580 AZ Primary
Assisted Living Facility (Behavioral Disturbances) 3104A0630X ALH-4580 AZ

Addresses

Primary practice location

17632 N 5TH PL
Phoenix, AZ 85022-1809

Mailing address

6501 E Greenway Pkwy
Suite 103, PMB 505
Scottsdale, AZ 85254-2065
Phone (602) 441-2563

National Provider Directory

National Provider Directory
Tax ID family
Liber Manor Residency 22 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1720174303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 E GREENWAY PKWY",
            "address_2": "SUITE 103, PMB 505",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852542065",
            "telephone_number": "602-441-2563",
            "fax_number": "602-354-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17632 N 5TH PL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850221809",
            "telephone_number": "602-441-2563",
            "fax_number": "602-354-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY MANOR RESIDENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "ROXAS",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-524-8124",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "ALH-4580",
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "AZ",
            "license": "ALH-4580",
            "primary": true
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "AZ",
            "license": "ALH-4580",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.