Provider Demographics
NPI:1982845830
Name:LIBERTY COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:LIBERTY COMMUNITY SERVICES, INC.
Other - Org Name:LIBERTY AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARNUM
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:215-464-7745
Mailing Address - Street 1:7002 W BUTLER PIKE
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-5107
Mailing Address - Country:US
Mailing Address - Phone:267-464-7745
Mailing Address - Fax:215-464-7755
Practice Address - Street 1:7002 W BUTLER PIKE
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-5107
Practice Address - Country:US
Practice Address - Phone:267-464-7745
Practice Address - Fax:215-464-7755
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIBERTY LUTHERAN SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPPLIED FOR251E00000X
PA17631601251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based