Organization Name: | LIBERTY REHABILITATION SERVICES |
NPI Number: | 1649433756 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TYRONE JAMES BANKS (OCCUPATIONAL THERAPIST) |
Mailing Address: | 3333 Northmont Rd Windsor Mill |
State: | MD US |
Postal Code: | 212442953 |
Phone Number: | 4436214884 |
Fax Number: | |
NPI Enumeration Date: | 07/08/2008 |
NPI Last Update Date: | 07/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320700000X |
License Number: | 05877 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MD |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Residential Treatment Facility, Physical Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |