Provider Demographics
NPI:1265711774
Name:TRUE LIBERTY CONCEPTS MANAGEMENT INC
Entity type:Organization
Organization Name:TRUE LIBERTY CONCEPTS MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:SEARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-308-8524
Mailing Address - Street 1:5010 SW 19TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33023-3271
Mailing Address - Country:US
Mailing Address - Phone:305-308-8524
Mailing Address - Fax:954-894-7019
Practice Address - Street 1:5010 SW 19TH ST
Practice Address - Street 2:
Practice Address - City:WEST PARK
Practice Address - State:FL
Practice Address - Zip Code:33023-3271
Practice Address - Country:US
Practice Address - Phone:305-308-8524
Practice Address - Fax:954-894-7019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14967253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL232113OtherSTATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION