NPIMap

Organization Active NPI

Liberty of Oklahoma Corporation

Doing business as Robert M. Greer Center

  • Mental Illness Intermediate Care Facility
  • Enid, OK
National Provider Identifier
1932286119
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Intermediate Care FacilityTaxonomy code 310500000X
Legal business name
LIBERTY OF OKLAHOMA CORPORATION
Doing business as
Robert M. Greer Center
Practice address
2616 North 30TH Street
Enid, OK 73701-8760
Phone
(580) 548-2699
Fax
(580) 213-2799
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Authorized official

Name
Hugh M. Sage, PHD
Title
Executive Director
Phone
(580) 213-2782

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Intermediate Care Facility 310500000X Primary
Intellectual Disabilities Intermediate Care Facility 315P00000X NH24142414 OK

Addresses

Primary practice location

2616 North 30TH Street
Enid, OK 73701-8760

Mailing address

2616 North 30TH Street
Enid, OK 73701-8760
Phone (580) 548-2699

Other identifiers 1

IdentifierTypeStateIssuer
100769310AMedicaidOK

Other names 1

  • Robert M. Greer Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Liberty of Oklahoma Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

2501 NE Delaware
Enid, OK 73701

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1932286119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2616 NORTH 30TH STREET",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737018760",
            "telephone_number": "580-548-2699",
            "fax_number": "580-213-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2616 NORTH 30TH STREET",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737018760",
            "telephone_number": "580-548-2699",
            "fax_number": "580-213-2799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY OF OKLAHOMA CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "SAGE",
        "authorized_official_first_name": "HUGH",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "580-213-2782",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "OK",
            "license": "NH24142414",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100769310A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robert M. Greer Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Robert M. Greer Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.