Provider Demographics
NPI:1861565517
Name:LIBERTY HOUSE
Entity type:Organization
Organization Name:LIBERTY HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAGGIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:FRANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-213-5009
Mailing Address - Street 1:15331 NORMANDY LANE
Mailing Address - Street 2:
Mailing Address - City:LAMIRANDA
Mailing Address - State:CA
Mailing Address - Zip Code:90638
Mailing Address - Country:US
Mailing Address - Phone:714-535-2943
Mailing Address - Fax:714-956-7303
Practice Address - Street 1:1133 N LIBERTY LANE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805
Practice Address - Country:US
Practice Address - Phone:714-535-2943
Practice Address - Fax:714-956-7303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness