LIBERTY HOUSE (NPI# 1144375049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144375049 |
| Entity Type | Organization |
| Organization Name | LIBERTY HOUSE |
| Practice Address |
1133 N Liberty Ln Anaheim CA 92805-1544 |
| Mailing Address |
15331 Normandy Ln La Mirada CA 90638-4745 |
| Practice Telephone | 7145352943 |
| Practice Fax Number | 7149567303 |
| Mailing Telephone | 7145352943 |
| Mailing Fax Number | 7149567303 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MAGIE FRANI (OWNER) |
| Authorized Official Telephone | 7142135009 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | CA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861565517 | Liberty House | Intermediate Care Facility, Mental Illness | 1133 N Liberty Lane, Anaheim, CA 92805 | 2006-11-17 |
| 1639244056 | Liberty House | Pediatrics | 2685 4th St Ne, Salem, OR 97301-6548 | 2006-11-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | LIBERTY HOUSE | 22609 Se 284th Ct, Maple Valley, WA 98038-4501 |
| Colorado Business Entities | Liberty House | 405 Cornell Ave., Fort Collins, CO 80425 |
| Oregon Corporations, Companies and Business Names | LIBERTY HOUSE | 2685 4th St Ne, Salem, OR 97301 |
| System for Award Management (SAM) Entities | LIBERTY HOUSE | 54 Bay St, Glens Falls, NY 12801-3028 |
| New York State Corporations | LIBERTY HOUSE FOUNDATION, INC. | 54 Bay Street, Glens Falls, Ny 12801 |
| Indiana Business Entities | LIBERTY HOUSE INC. | 248 Locust, Hammond, IN 46324 |
| Connecticut Business Registrations | LIBERTY HOUSE INTERNATIONAL CHURCH, INC. | 647 Tolland Turnpike, Manchester, CT 06040 |
| Massachusetts Corporations | LIBERTY HOUSE LLC | 1776 Commonwealth Ave, Unit 1, Brighton, MA 02135 |
| Oklahoma Business Registrations | LIBERTY HOUSE LLC | 1805 North Road, Snyder, OK 73566 |
| Virginia Business Entities | Liberty House LLC | 7 South Liberty Street, Po Box 1577, Middleburg, Virginia 20118 |
| Street Address |
1133 N LIBERTY LN |
| City | ANAHEIM |
| State | CA |
| Zip Code | 92805-1544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841840097 | Jesus Jaime Rodriguez | Technician | 805 N. Pauline St., Anaheim, CA 92805 | 2019-09-18 |
| 1225680994 | Michael Cross | Counselor | 710 N. Anaheim Blvd Anaheim, Ca 92805, 710 N.anaheim Blvd, Anaheim, CA 92805 | 2019-07-12 |
| 1588123459 | Dania Jesri | Behavior Technician | 300 N Avelia Way, Anaheim, CA 92805 | 2019-03-19 |
| 1346708872 | Tiffany Chauvet | Behavior Technician | 1300 East Orangewood Ave, Anaheim, CA 92805 | 2019-03-04 |
| 1972087740 | Jehanzeb Shahab Khairi | Behavior Technician | 3101 E Orangewood Ave, Anaheim, CA 92805 | 2018-09-18 |
| 1033693825 | Baotran Minh Le | Behavior Technician | 3101 E. Orangewood Ave., Anaheim, CA 92805 | 2018-09-18 |
| 1841778354 | Jonathan Besuamlak | Behavior Technician | 1301 E. Orangewood Ave., Anaheim, CA 92805 | 2018-08-06 |
| 1700364973 | Erica Vanderlinden | Behavioral Analyst | 1301 East Orangewood Avenue, Anaheim, CA 92805 | 2018-07-31 |
| 1578054391 | Us Care Transportation LLC | Non-emergency Medical Transport (VAN) | 248 S Seneca Cir, Anaheim, CA 92805 | 2018-05-29 |
| 1578081691 | Christopher Mills | Counselor | 1025 S. Anaheim Blvd, Anaheim, CA 92805 | 2017-09-08 |
| Find all providers in zip 92805 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003360900 | Afestin Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2107 W Grayson Ave, Anaheim, CA 92801-1621 | 2016-08-09 |
| 1982034898 | Villa De Martin Jude Homes Archer 2 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 320 S Archer St, Anaheim, CA 92804-2418 | 2013-11-14 |
| 1316377229 | Villa De Martin Jude Homes Atlanta House | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2204 S Atlanta St, Anaheim, CA 92802-3905 | 2013-11-14 |
| 1053740878 | Tri-elizabeth Homes | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 207 N Bel Air St, Anaheim, CA 92801-6205 | 2013-11-02 |
| 1811326739 | New Horizon Integrated Care, Icf-dd-home, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2660 W Trojan Pl, Anaheim, CA 92804-2029 | 2013-11-01 |
| 1164501912 | New Horizon Interated Care, Icf-dd Home Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8812 Athens Ct, Anaheim, CA 92804-6204 | 2006-11-03 |
| 1922187772 | Snch Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 327 N Sunkist St, Anaheim, CA 92806 | 2006-11-03 |
| 1316021942 | Pilar M. De Castro & Co. Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 804 N Magnolia Ave, Anaheim, CA 92801-3109 | 2006-10-24 |
| 1194808261 | Villa De Martin Jude Homes, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 520 S Archer St, Anaheim, CA 92804-2422 | 2006-10-23 |
| 1043234487 | Sunrise Home Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 306 N Siesta St, Anaheim, CA 92801-5117 | 2006-07-27 |
| Find all providers in ANAHEIM | ||||
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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.