Liberty Village Senior Communities Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

2020 RCF Issued in OH

Legal business name

LIBERTY VILLAGE SENIOR COMMUNITIES INC

Doing business as

Liberty Village

Practice address

1839 Western Ave
Chillicothe, OH 45601

Phone

(740) 773-4630

Fax

(740) 773-4648

NPI assigned

Aug 13, 2014

Organization subpart

No

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

Authorized official

Name

Mr. J Michael Haemmerle

Title

President

Phone

(614) 799-4447

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Liberty Village Doing business as

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1750790960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 VENTURE DRIVE",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "43017",
            "telephone_number": "614-798-5110",
            "fax_number": "614-798-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 WESTERN AVE",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "45601",
            "telephone_number": "740-773-4630",
            "fax_number": "740-773-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY VILLAGE SENIOR COMMUNITIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-13",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "HAEMMERLE",
        "authorized_official_first_name": "J MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-799-4447",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "2020 RCF",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "385459727",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RCF LICENSE",
            "identifier": "2020 RCF",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Village",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Liberty Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Nicole Lewis, RN
• Mildred K Lewis
• Sarah Lewis, RN
• Thomas Glenn Lewis, M.D.
• Siyun Li, MD
• Roslynn Ranae Liggett, CCHW
• Emily R Lightle, CNP
• Joanie Lightle, OTA
• Ling Lin, DO
• Lincare Inc.

• Assisted Living Facility in Chillicothe, OH
• Providers in Chillicothe, OH by specialty
• Assisted Living Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.