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LIBERTY HOUSE RECOVERY LLC NPI 1861145823


NPI Information

NPI: 1861145823
Provider Name: LIBERTY HOUSE RECOVERY, LLC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 05D2273472

Address:
710 THE TER
REDLANDS, CA
ZIP 92374
Phone: (909) 754-1712
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LIBERTY HOUSE RECOVERY, LLC is a substance abuse rehabilitation facility in Redlands, CA. 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 HOUSE RECOVERY, LLC NPI is 1861145823. The provider is registered as an organization entity type.

The provider's business location address is:

710 THE TER
REDLANDS, CA
ZIP 92374-465
Phone: (909) 754-1712

The provider's authorized official is Lacey Leigh Ursich .
The authorized official title is Ceo and has the following contact phone number (909) 754-1712.

The CLIA number assigned to this NPI record is 05D2273472 - other - detox residential with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/31/2022 and was last updated on 3/16/2022.


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
1324500000XSubstance Abuse Rehabilitation FacilityYes

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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