NPIMap

Organization Active NPI

Liberty Healthcare Systems

  • Psychiatric Hospital
  • Bastrop, LA
National Provider Identifier
1962603142
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
573 Issued in LA
Legal business name
LIBERTY HEALTHCARE SYSTEMS
Practice address
4673 Eugene Ware Blvd
Bastrop, LA 71220-1425
Phone
(318) 281-2448
Fax
(318) 281-2499
NPI assigned
May 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Radian Hennigan
Title
Cfo
Phone
(318) 251-9458

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 573 LA Primary

Addresses

Primary practice location

4673 Eugene Ware Blvd
Bastrop, LA 71220-1425

Mailing address

4673 Eugene Ware Blvd
Bastrop, LA 71220-1425
Phone (318) 281-2448

Other identifiers 1

IdentifierTypeStateIssuer
1453676MedicaidLA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962603142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4673 EUGENE WARE BLVD",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712201425",
            "telephone_number": "318-281-2448",
            "fax_number": "318-281-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4673 EUGENE WARE BLVD",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712201425",
            "telephone_number": "318-281-2448",
            "fax_number": "318-281-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HEALTHCARE SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENNIGAN",
        "authorized_official_first_name": "RADIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "318-251-9458",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "LA",
            "license": "573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1453676",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bastrop, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.