LIBERATION, LLC


Address: 802 N. 5th, Pnoenix, AZ 85003-1316
Phone: 6027089014

LIBERATION, LLC (NPI# 1518382274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1518382274
Entity Type Organization
Organization Name LIBERATION, LLC
Practice Address 802 N. 5th
Pnoenix
AZ 85003-1316
Mailing Address 802 N 5th Ave
Phoenix
AZ 85003-1316
Practice Telephone 6027089014
Practice Fax Number 8883491581
Mailing Telephone 6025594922
Mailing Fax Number 8883491581
Enumeration Date 2014-03-04
Last Update Date 2014-03-04
Authorized Official Name DR. ADEOLA ADELAYO (CEO)
Authorized Official Telephone 6027089014
Authorized Official Credential M.D
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM1300X Clinic/Center
Specialization: Multi-Specialty
OTC5977 AZ Ambulatory Health Care Facilities

Other Data Sources

Entity Type Entity Name Entity Address
Colorado Business Entities Liberation, LLC 1943 S Niagara St, Denver, CO 80224
Connecticut Business Registrations LIBERATION, LLC 22 Senior Drive, Easton, CT 06612
New York State Corporations LIBERATION, LLC 10 Bogardus Rd, Albany, Ny 12208

Office Location

Street Address 802 N. 5TH
City PNOENIX
State AZ
Zip Code 85003-1316

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Taxonomy Information

Taxonomy Code 261QM1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Multi-Specialty

Taxonomy Definition

Definition to come...

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Competitor

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City PNOENIX
Zip Code 85003

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Dataset Information

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.

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