Provider Demographics
NPI:1659021921
Name:LIBERTY HOME CARE PLLC
Entity Type:Organization
Organization Name:LIBERTY HOME CARE PLLC
Other - Org Name:LIBERTY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-360-9536
Mailing Address - Street 1:4255 WINDEMERE WAY
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-6263
Mailing Address - Country:US
Mailing Address - Phone:319-360-9536
Mailing Address - Fax:
Practice Address - Street 1:4255 WINDEMERE WAY
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-6263
Practice Address - Country:US
Practice Address - Phone:319-360-9536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No251J00000XAgenciesNursing Care