Provider Demographics
NPI:1790136349
Name:LIBERTY HOME CARE LLC
Entity Type:Organization
Organization Name:LIBERTY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINITRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DURGA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-989-0651
Mailing Address - Street 1:1390 S POTOMAC ST STE 116
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4529
Mailing Address - Country:US
Mailing Address - Phone:720-989-0651
Mailing Address - Fax:
Practice Address - Street 1:19073 E LINVALE PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-4781
Practice Address - Country:US
Practice Address - Phone:720-989-0651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-24
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health