Provider Demographics
NPI:1659172088
Name:LIBERTY HOME CARE NURSING AGENCY LLC
Entity type:Organization
Organization Name:LIBERTY HOME CARE NURSING AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-750-3844
Mailing Address - Street 1:4500 E WEST HWY STE 150
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3327
Mailing Address - Country:US
Mailing Address - Phone:512-750-3844
Mailing Address - Fax:301-560-5143
Practice Address - Street 1:1660 INTERNATIONAL DR STE 600
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-4877
Practice Address - Country:US
Practice Address - Phone:301-263-6941
Practice Address - Fax:301-560-5143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health