LIBERTY ENTERPRISES INC. (NPI# 1902923394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902923394 |
| Entity Type | Organization |
| Organization Name | LIBERTY ENTERPRISES INC. |
| Practice Address |
1304 W Mack Ave Marion IL 62959-4510 |
| Practice Telephone | 6189979336 |
| Mailing Telephone | 6189979336 |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. STEPHEN R. BROWN (ADMINISTRATOR) |
| Authorized Official Telephone | 6189979336 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 0037085 | IL | Nursing & Custodial Care Facilities |
| Street Address |
1304 W MACK AVE |
| City | MARION |
| State | IL |
| Zip Code | 62959-4510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710513486 | Sarah Benitone | Counselor | 11264 Il-37, Marion, IL 62959 | 2020-03-13 |
| 1528609328 | Patricia E Murphy | Radiology | 4503 1/2 W Deyoung, Suite 3a, Marion, IL 62959 | 2019-10-02 |
| 1366007007 | Centerstone of Illinois, Inc | Community/Behavioral Health | 202 S Bentley St, Marion, IL 62959 | 2019-05-08 |
| 1649752064 | Sydney Seiter | Occupational Therapist | 906 Skyline Suite 100, Marion, IL 62959 | 2018-09-01 |
| 1497279848 | Brooke Alisa Osman | Licensed Practical Nurse | 11531 Sunderland Road, Marion, IL 62959 | 2017-07-27 |
| 1912436429 | Joy L. Kee | Social Worker | 509 South Bentley Street, Marion, IL 62959 | 2017-06-08 |
| 1386181170 | Susan Smothers | Counselor | 1305 West Main Street, Marion, IL 62959 | 2017-01-31 |
| 1205280922 | Harish Kempegowda | Orthopaedic Surgery | 3331 W Deyoung St Ste 201, Marion, IL 62959 | 2016-04-19 |
| 1942609227 | Casey Hill | Social Worker | 1604 W. Walnut St., Marion, IL 62959 | 2014-08-22 |
| 1306252812 | Justin M White | Chiropractor | 1603 W Kimmel, Marion, IL 62959 | 2014-07-03 |
| Find all providers in zip 62959 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659568830 | Voca Corporation of Ohio | Intermediate Care Facility, Mentally Retarded | 340 James Way, Marion, OH 43302-5883 | 2007-10-01 |
| 1891814554 | Rescare Inc | Intermediate Care Facility, Mentally Retarded | 131 N Washington St, Marion, IN 46952-2803 | 2007-03-27 |
| 1043342157 | Comserv, Inc. | Intermediate Care Facility, Mentally Retarded | 109 Lonon Ave, Marion, NC 28752 | 2007-03-12 |
| 1629132709 | Rem Iowa, Inc | Intermediate Care Facility, Mentally Retarded | 1490 Daleview Dr, Marion, IA 52302-5211 | 2006-12-21 |
| 1619039096 | Rem Iowa, Inc | Intermediate Care Facility, Mentally Retarded | 3025 8th St, Marion, IA 52302-5416 | 2006-12-14 |
| 1407968779 | Care Star | Intermediate Care Facility, Mentally Retarded | 682 Harding Rd, Marion, OH 43302-5431 | 2006-08-31 |
| 1053421974 | Res-care, Inc | Intermediate Care Facility, Mentally Retarded | 221 N Washington St, Marion, IN 46952-2707 | 2006-08-30 |
| 1053577049 | Res-care, Inc. | Intermediate Care Facility, Mentally Retarded | 131 N Washington St, Marion, IN 46952-2803 | 2008-07-30 |
| 1407024813 | Rescare Inc | Intermediate Care Facility, Mentally Retarded | 201 N Baldwin Ave, Marion, IN 46952-3533 | 2008-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871039669 | Mount St Joseph | Intermediate Care Facility, Mentally Retarded | 24955 N Us Highway 12, Lake Zurich, IL 60047-8919 | 2017-01-17 |
| 1447792221 | Shore Community Services, Inc. | Intermediate Care Facility, Mentally Retarded | 8350 Laramie Ave, Skokie, IL 60077-2461 | 2016-11-10 |
| 1770930968 | Community Support Systems | Intermediate Care Facility, Mentally Retarded | 2311 Veterans Drive, Effingham, IL 62401 | 2016-05-18 |
| 1265898266 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 102 S Douglas St, Mc Leansboro, IL 62859-1637 | 2016-01-06 |
| 1164888160 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 1406 W Delaware St, Fairfield, IL 62837-2336 | 2016-01-06 |
| 1376909374 | Tdl Group, Inc | Intermediate Care Facility, Mentally Retarded | 416 Chula Vista Dr, Belleville, IL 62221-3160 | 2016-01-06 |
| 1437515434 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 206 N Washington St, Mc Leansboro, IL 62859-1049 | 2016-01-06 |
| 1790141885 | Tdl Group, Inc | Intermediate Care Facility, Mentally Retarded | 212 Turning Leaf Cir, Belleville, IL 62221-6747 | 2016-01-06 |
| 1790141794 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 867 County Road 2150 E, Fairfield, IL 62837-2824 | 2016-01-06 |
| 1255797254 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 9135 N Spring Garden Ln, Mount Vernon, IL 62864-6624 | 2016-01-06 |
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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.