Provider Demographics
NPI:1023606589
Name:LIBERTY MANOR
Entity type:Organization
Organization Name:LIBERTY MANOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANGER/ CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-432-0444
Mailing Address - Street 1:9259 LIBERTY SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-9589
Mailing Address - Country:US
Mailing Address - Phone:740-432-0444
Mailing Address - Fax:740-432-0491
Practice Address - Street 1:9259 LIBERTY SCHOOL RD
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-9589
Practice Address - Country:US
Practice Address - Phone:740-432-0444
Practice Address - Fax:740-432-0491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-08
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty