LIBERTY HOUSE (NPI# 1639244056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639244056 |
| Entity Type | Organization |
| Organization Name | LIBERTY HOUSE |
| Practice Address |
2685 4th St Ne Salem OR 97301-6548 |
| Practice Telephone | 5035400288 |
| Practice Fax Number | 5035400293 |
| Mailing Telephone | 5035400288 |
| Mailing Fax Number | 5035400293 |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2007-09-06 |
| Authorized Official Name | GRETCHEN BENNETT (DIRECTOR) |
| Authorized Official Telephone | 5035400288 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 139463 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144375049 | Liberty House | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1133 N Liberty Ln, Anaheim, CA 92805-1544 | 2007-01-24 |
| 1861565517 | Liberty House | Intermediate Care Facility, Mental Illness | 1133 N Liberty Lane, Anaheim, CA 92805 | 2006-11-17 |
| 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 |
2685 4TH ST NE |
| City | SALEM |
| State | OR |
| Zip Code | 97301-6548 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760596779 | Kathy Martilla Butler | Physician Assistant | 2685 4th St Ne, Salem, OR 97303-6548 | 2006-08-18 |
| 1790850105 | Lauren Mcnaughton | Pediatrics | 2685 4th St Ne, Salem, OR 97301-6548 | 2006-11-21 |
| 1033284450 | Elizabeth Graves Griffin | Nurse Practitioner | 2685 4th St Ne, Salem, OR 97301 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
| 1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
| 1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
| 1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| Find all providers in zip 97301 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730440058 | Matthew Hatler | Pediatrics | 2478 13th St. Se, Salem, OR 97302-2546 | 2012-06-04 |
| 1033409016 | William Christopher Thomsen Jr. | Pediatrics | 1641 Millwood Dr, Salem, VA 24153-4616 | 2011-04-12 |
| 1275708539 | Children's Medical Group | Pediatrics | 24906 75th St, Salem, WI 53168-9705 | 2008-04-28 |
| 1346378213 | Cooper Pediatrics | Pediatrics | 330 Woodstown Road., Medical Arts Bldg 7, Salem, NJ 08079 | 2007-03-01 |
| 1053424291 | Linda J Morgan | Pediatrics | 57 Highlands Ave, Er, Salem, MA 01970 | 2006-08-15 |
| 1700813854 | Dorin Meredith Kemmerle | Pediatrics | 4350 Commercial St Se, Salem, OR 97302-3914 | 2006-06-26 |
| 1043252612 | Kimberly Ann Heggen | Pediatrics | 891 23rd St Ne, Salem, OR 97301-1793 | 2006-06-11 |
| 1770525263 | Fara Katrina Etzel | Pediatrics | 2395 Center St Ne, Salem, OR 97301-4464 | 2006-06-11 |
| 1083675953 | Donald T Mcauliffe | Pediatrics | 72 Highland Avenue, Pediatric Associates of Greater Salem, Salem, MA 01970 | 2006-03-30 |
| 1336116474 | Madeleine Ana Ortiz | Pediatrics | 1076 E State St, Salem, OH 44460-2228 | 2006-03-08 |
| Find all providers in SALEM | ||||
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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.