LIBERTY ENTERPRISES INC. NPI 1902923394

NPI Information

NPI: 1902923394
Provider Name: LIBERTY ENTERPRISES INC.
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
1304 W MACK AVE
MARION, IL
ZIP 62959
Phone: (618) 997-9336
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LIBERTY ENTERPRISES INC. is an intermediate care facility mentally retarded in Marion, IL. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. LIBERTY ENTERPRISES INC. NPI is 1902923394. The provider is registered as an organization entity type.

The provider's business location address is:

1304 W MACK AVE
MARION, IL
ZIP 62959-510
Phone: (618) 997-9336

The provider's authorized official is Stephen R. Brown .
The authorized official title is Administrator and has the following contact phone number (618) 997-9336.

The enumeration date for this NPI number is 3/23/2007 and was last updated on 8/22/2020.

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	315P00000X	Intermediate Care Facility, Intellectual Disabilities		0037085	ILLINOIS	Yes

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: 5/5/2024

NPI Synchronization or Removal

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