Provider Demographics
NPI:1790032712
Name:LIBERTY AND ASSOCIATES, INC.
Entity Type:Organization
Organization Name:LIBERTY AND ASSOCIATES, INC.
Other - Org Name:FAVORED HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHIBUEZE
Authorized Official - Middle Name:
Authorized Official - Last Name:OKWARAOHA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:404-401-0266
Mailing Address - Street 1:1945 FOSTER TRACE CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-6545
Mailing Address - Country:US
Mailing Address - Phone:404-401-0266
Mailing Address - Fax:770-338-7716
Practice Address - Street 1:1945 FOSTER TRACE CT
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-6545
Practice Address - Country:US
Practice Address - Phone:404-401-0266
Practice Address - Fax:770-338-7716
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIBERTY AND ASSOCIATES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN208307251B00000X, 251J00000X
GA067-R-0958251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care