LIBERTY RESOURCES INC. NPI 1639729452

NPI Information

NPI: 1639729452
Provider Name: LIBERTY RESOURCES, INC.
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
1045 JAMES ST
SYRACUSE, NY
ZIP 13203
Phone: (315) 472-4471
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LIBERTY RESOURCES, INC. is a substance abuse rehabilitation facility in Syracuse, NY. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. LIBERTY RESOURCES, INC. NPI is 1639729452. The provider is registered as an organization entity type.

The provider's business location address is:

1045 JAMES ST
SYRACUSE, NY
ZIP 13203-730
Phone: (315) 472-4471

The provider's authorized official is Kelli Harris .
The authorized official title is Cfo and has the following contact phone number (315) 425-1004.

The enumeration date for this NPI number is 9/13/2019 and was last updated on 9/13/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility				Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	02994810	MEDICAID	NEW YORK

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

NPI Synchronization or Removal

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