Active NPI
Liberty Pine Recovery LLC
Doing business as Lifeline Recovery and Wellness
- Substance Abuse Rehabilitation Facility
- Malvern, PA
National Provider Identifier
1932991049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Abuse Rehabilitation Facility
- Legal business name
- LIBERTY PINE RECOVERY LLC
- Doing business as
- Lifeline Recovery and Wellness
- Practice address
- 255 Great Valley Pkwy Ste 200
Malvern, PA 19355-1300 - Phone
- (856) 693-3007
- NPI assigned
- May 22, 2025
- Last updated
- May 22, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert Whedon
- Title
- Member/Partner
- Phone
- (856) 693-3007
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | NU | Primary |
Addresses
Primary practice location
255 Great Valley Pkwy Ste 200
Malvern, PA 19355-1300
Mailing address
255 Great Valley Pkwy Ste 200
Malvern, PA 19355-1300
Other names 1
- Lifeline Recovery and Wellness
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D2331217 | Liberty Pine Recovery LLC | Certificate of waiver | Sep 28, 2027 |
National Provider Directory
National Provider DirectoryLocations
255 Great Valley Pkwy
Ste 200
Malvern, PA 19355
Phone (856) 693-3007
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747872000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1747872000000",
"number": "1932991049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 GREAT VALLEY PKWY STE 200",
"city": "MALVERN",
"state": "PA",
"postal_code": "193551300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 GREAT VALLEY PKWY STE 200",
"city": "MALVERN",
"state": "PA",
"postal_code": "193551300",
"telephone_number": "856-693-3007"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIBERTY PINE RECOVERY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-05-22",
"last_updated": "2025-05-22",
"certification_date": "2025-05-22",
"status": "A",
"authorized_official_last_name": "WHEDON",
"authorized_official_first_name": "ROBERT",
"authorized_official_title_or_position": "MEMBER/PARTNER",
"authorized_official_telephone_number": "856-693-3007"
},
"taxonomies": [
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Lifeline Recovery and Wellness",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Malvern, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.