LIBERTY FAMILY CARE (NPI# 1124640974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1124640974 |
Entity Type | Organization |
Organization Name | LIBERTY FAMILY CARE |
Practice Address |
8515 Liberty Rd Ste B Randallstown MD 21133-4832 |
Mailing Address |
3202 Greenmead Rd Windsor Mill MD 21244-1134 |
Practice Telephone | 4103016767 |
Mailing Telephone | 4103016767 |
Enumeration Date | 2020-05-15 |
Last Update Date | 2020-05-15 |
Authorized Official Name | DR. BOLAJI O OLUGBOJA (DR.) |
Authorized Official Telephone | 4103016767 |
Authorized Official Credential | DNP |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083663892 | Liberty Family Care | Family Medicine | 300 W Front St, Liberty, SC 29657-1012 | 2006-05-09 |
Street Address |
8515 LIBERTY RD STE B |
City | RANDALLSTOWN |
State | MD |
Zip Code | 21133-4832 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649898313 | Olivia David | Registered Nurse | 3525 Liberty Resource Drive, Randallstown, MD 21133 | 2020-07-09 |
1366082547 | Jerry Njomgert Christopher | Home Health Aide | 9106 Sandra Ct. Randallstown, Randallstown, MD 21133 | 2020-01-15 |
1487138913 | For Hope's Sake, LLC | Substance Abuse Rehabilitation Facility | 9905 Southhall Road, Randallstown, MD 21133 | 2018-09-20 |
1295214393 | Levindale Hebrew Geriatric Center & Hospital Inc | Clinic/Center | Lifebridge Health Adult Day Services, 5400 Old Court Road, Randallstown, MD 21133 | 2018-08-09 |
1235623968 | Away of Change Counseling Service, LLC | Counselor | 5310 Old Court Rd Ste 304, Randallstown, MD 21133 | 2018-06-16 |
1922503382 | Top Care Residential Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8607 Liberty Rd, Randallstown, MD 21133 | 2018-03-28 |
1497274880 | Yushika M Shepherd | In Home Supportive Care | 8911 Allenswood Rd, Randallstown, MD 21133 | 2017-09-17 |
1790208718 | Productive Lives Mental Health, LLC | Clinic/Center | Randallstown Medical Center 5310 Old Court Rd Suite 308, Randallstown, MD 21133 | 2017-07-21 |
1982136198 | Marla Rosanne Yee | Dentist | 5415 Old Court Road, Suite 01, Randallstown, MD 21133 | 2017-03-28 |
1598203549 | Traci Harris | Social Worker | 9633 Liberty Rd. (suites H&j), Randallstown, MD 21133 | 2017-02-09 |
Find all providers in zip 21133 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891304887 | Gideon Tah Fon | Nurse Practitioner | 6 Rock Story Ct, None, Randallstown, MD 21133-2844 | 2020-07-27 |
1679190292 | Abigael O Olaleye | Nurse Practitioner | 4224 Mary Ridge Dr, Randallstown, MD 21133-4321 | 2020-06-30 |
1407480817 | Sunny Besong Diffang | Nurse Practitioner | 3523 Corn Stream Rd, Randallstown, MD 21133-2442 | 2020-02-24 |
1316571722 | Morgan Ariel Murray | Nurse Practitioner | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-02-24 |
1811527278 | Ifeoma Jennifer Dunn | Nurse Practitioner | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-01-23 |
1598395725 | Ayodeji Bamidele Olawale | Nurse Practitioner | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-01-15 |
1336779578 | Lerin Jackson | Nurse Practitioner | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-01-15 |
1053820621 | Alimatu Kosnatu Nabie | Nurse Practitioner | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2017-09-26 |
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1821697533 | Brighter Days Recovery Center | Nurse Practitioner | 2439 E Lafayette Ave, Baltimore, MD 21213-2562 | 2020-10-23 |
1033718762 | White Plains Primary Care | Nurse Practitioner | 50 Post Office Rd Ste 304, Waldorf, MD 20602-3704 | 2020-10-23 |
1245839653 | Itoro Abatai | Nurse Practitioner | 9620 Maxwell Rd, Middle River, MD 21220-3792 | 2020-10-19 |
1992304372 | Catherine Koskei | Nurse Practitioner | 2295 Lowell Ridge Rd Apt B, Parkville, MD 21234-2370 | 2020-10-18 |
1194323857 | Meliora Davies | Nurse Practitioner | 206 Settlers Way, Upper Marlboro, MD 20774-5770 | 2020-10-14 |
1932707171 | David Mwangi | Nurse Practitioner | 27 Blue Spire Cir, Middle River, MD 21220-1743 | 2020-10-10 |
1750989042 | Osereme Nora Agboifo | Nurse Practitioner | 200 Ejoppa Rd Suite 106, Townson, MD 21286 | 2020-10-09 |
1639776446 | Serenity Heart Healthcare, LLC | Nurse Practitioner | 6755 Business Pkwy Ste 304, Elkridge, MD 21075-6740 | 2020-10-05 |
1689281529 | Premier Psychiatry, LLC | Nurse Practitioner | 10601 Virginia Ave, Cockeysville, MD 21030-2315 | 2020-09-24 |
1407462559 | Mem Scepter Home & Behavioral | Nurse Practitioner | 14104 Dawn Whistle Way, Bowie, MD 20721-1304 | 2020-09-23 |
Find all providers with the same taxonomy |
City | RANDALLSTOWN |
Zip Code | 21133 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.