Provider Demographics
NPI:1881129609
Name:LIBERTY PARTNER LLC
Entity type:Organization
Organization Name:LIBERTY PARTNER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:WELBAUM
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:616-719-7358
Mailing Address - Street 1:235 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-2712
Mailing Address - Country:US
Mailing Address - Phone:517-920-4254
Mailing Address - Fax:888-306-0434
Practice Address - Street 1:235 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-2712
Practice Address - Country:US
Practice Address - Phone:517-920-4254
Practice Address - Fax:888-306-0434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-30
Last Update Date:2017-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health