Provider Demographics
NPI:1679157424
Name:LIBERTY PALLIATIVE AND HOSPICE HOME CARE SERVICES
Entity Type:Organization
Organization Name:LIBERTY PALLIATIVE AND HOSPICE HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-720-4751
Mailing Address - Street 1:2926 W MANCHESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-2439
Mailing Address - Country:US
Mailing Address - Phone:818-720-4751
Mailing Address - Fax:310-412-0878
Practice Address - Street 1:2926 W MANCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90305-2439
Practice Address - Country:US
Practice Address - Phone:818-720-4751
Practice Address - Fax:310-412-0878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based