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LIBERTY I LLC NPI 1588616015


NPI Information

NPI: 1588616015
Provider Name: LIBERTY I, LLC

Doing Business As: CONCIERGE HOME CARE

Classification: Home Health - 251E00000X
Entity Type: Organization

CLIA Number: 10D1011161

Address:
5810 W CYPRESS ST STE 5810-A
TAMPA, FL
ZIP 33607
Phone: (813) 636-5017
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LIBERTY I, LLC is a home health in Tampa, FL. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. LIBERTY I, LLC NPI is 1588616015. The provider is registered as an organization entity type.
The provider Is Doing Business As Concierge Home Care.

The provider's business location address is:

5810 W CYPRESS ST STE 5810-A
TAMPA, FL
ZIP 33607-780
Phone: (813) 636-5017
Fax: (813) 282-1166

The provider's authorized official is Robert G Young .
The authorized official title is Secretary & Cao and has the following contact phone number (904) 733-1003.

The CLIA number assigned to this NPI record is 10D1011161 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/16/2006 and was last updated on 12/27/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251E00000XHome HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
110D1011161OTHERFLORIDACLIA WAIVER ID
2299992257OTHERFLORIDAAHCA STATE LICENSE
3111117900MEDICAIDFLORIDA
4299991756OTHERFLORIDAAHCA STATE LICENSE
5299992984OTHERFLORIDAAHCA STATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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