Provider Demographics
NPI:1730220716
Name:LIBERTY HOME CARE INC
Entity type:Organization
Organization Name:LIBERTY HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAIDU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-942-7660
Mailing Address - Street 1:37799 PROFESSIONAL CENTER DR
Mailing Address - Street 2:STE 103
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-1153
Mailing Address - Country:US
Mailing Address - Phone:734-942-7660
Mailing Address - Fax:734-942-7662
Practice Address - Street 1:37799 PROFESSIONAL CENTER DR
Practice Address - Street 2:STE 103
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1153
Practice Address - Country:US
Practice Address - Phone:734-942-7660
Practice Address - Fax:734-942-7662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-10
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237543Medicare ID - Type Unspecified