Provider Demographics
NPI:1851750954
Name:LIBERTY HEALTH SYSTEM LLC
Entity Type:Organization
Organization Name:LIBERTY HEALTH SYSTEM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-230-0260
Mailing Address - Street 1:11703 BEECHNUT ST UNIT 720551
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77272-0609
Mailing Address - Country:US
Mailing Address - Phone:832-230-0260
Mailing Address - Fax:
Practice Address - Street 1:14007 RIVER KEG DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-6507
Practice Address - Country:US
Practice Address - Phone:832-230-0260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health