Provider Demographics
NPI:1952576720
Name:CEDARS OF LIBERTY INC
Entity Type:Organization
Organization Name:CEDARS OF LIBERTY INC
Other - Org Name:CEDARS OF LIBERTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-781-7600
Mailing Address - Street 1:200 W RUTH EWING RD
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-9496
Mailing Address - Country:US
Mailing Address - Phone:816-781-7600
Mailing Address - Fax:816-781-0340
Practice Address - Street 1:200 W RUTH EWING RD
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-9496
Practice Address - Country:US
Practice Address - Phone:816-781-7600
Practice Address - Fax:816-781-0340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO035517310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility