Liberty Care LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LIBERTY CARE LLC

Practice address

10820 Direct River Dr NW
Coon Rapids, MN 55433-3923

Phone

(651) 354-9760

NPI assigned

Jun 29, 2024

Organization subpart

No

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

Authorized official

Name

Miss Omowunmi Mariam Bayo, PROVIDER

Title

Owner

Phone

(651) 354-9760

Specialties & licenses 1

Addresses

Other names 1

• Liberty Care LLC 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

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

{
    "created_epoch": "1719619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1902641038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 PARK ST APT 215",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103795",
            "telephone_number": "651-354-9760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10820 DIRECT RIVER DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333923",
            "telephone_number": "651-354-9760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-29",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "BAYO",
        "authorized_official_first_name": "OMOWUNMI",
        "authorized_official_middle_name": "MARIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-354-9760",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "PROVIDER"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Care LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amie-Jo Leshovsky, RDH
• Kelsey Lessard, DNP, APRN, CNP
• Jennifer Jean Lewis, PT
• Deborah L Leyh, CRNA
• Richard G Leyh, CRNA
• Liberty Oxygen and Home Care, Inc
• Megan Marie Lidtke
• Lifearc Ventures
• Lighted Pathways Therapy, LLC
• Ibukunoluwa Lijadu

• Assisted Living Facility in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.