LIBERTY STREET FACILITY (NPI# 1902963705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902963705 |
| Entity Type | Organization |
| Organization Name | LIBERTY STREET FACILITY |
| Practice Address |
125 Liberty St Suite 206 Springfield MA 01103-1114 |
| Practice Telephone | 4137464800 |
| Mailing Telephone | 4137464800 |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DAVID M CHADBOURNE (OWNER) |
| Authorized Official Telephone | 4137464800 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
59098 | MA | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | LIBERTY STREET FACILITY, LLC | 100 Wason Ave. Ste. 240, Springfield, MA 01107 |
| Street Address |
125 LIBERTY ST SUITE 206 |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01103-1114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619977402 | Peter T Demos | Dermatology | 125 Liberty St, Springfield, MA 01103-2961 | 2005-07-22 |
| 1881206241 | Carl Amyas Taylor | Counselor | 125 Liberty St, Springfield, MA 01103-1114 | 2020-08-18 |
| 1346892437 | L&l Life Enrichment Center LLC | Psychologist | 125 Liberty St, Springfield, MA 01103-1114 | 2019-07-10 |
| 1912440892 | Metrocare of Springfield | Nursing Care | 125 Liberty St, Suite 404, Springfield, MA 01103-1114 | 2016-11-28 |
| 1730622614 | Metrocare of Springfield | Custodial Care Facility | 125 Liberty St, Springfield, MA 01103-1114 | 2016-11-28 |
| 1215384409 | Adult and Geriatric Medicine Partners, L.L.C. | Family Medicine | 125 Liberty St, Suite 403, Springfield, MA 01103-1114 | 2016-05-18 |
| 1457717795 | Metrocare of Springfield LLC | In Home Supportive Care | 125 Liberty St, Suite 404, Springfield, MA 01103-1109 | 2015-12-31 |
| 1457729741 | Right Choice Health Group LLC | Clinic/Center | 125 Liberty St, Suite 205, Springfield, MA 01103-1114 | 2015-09-03 |
| 1730557018 | Mindcare Agency PC | Community/Behavioral Health | 125 Liberty St, Suite 205, Springfield, MA 01103-1114 | 2015-09-03 |
| 1427431402 | Nicole Dacampo | Registered Nurse | 125 Liberty St, Suite 205, Springfield, MA 01103-1114 | 2015-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336790609 | Mahmoud Al Homsi | Dentist | 41 Taylor St. 4th Fl, Springfield, MA 01103 | 2019-09-26 |
| 1427521749 | Pedro Cruz | Student in an Organized Health Care Education/Training Program | 95 Frank B Murray, Springfield, MA 01103 | 2019-01-09 |
| 1003325010 | Amber Lynn Chisholm | Counselor | 130 Maple St., Springfield, MA 01103 | 2017-09-21 |
| 1750737391 | Mande' Counseling | Community/Behavioral Health | 1365 Main St Suite 401, Springfield, MA 01103 | 2016-05-13 |
| 1528467248 | Amanda M Galloway | Physician Assistant | 1038-1050 Main St, Springfield, MA 01103 | 2014-08-19 |
| 1114326113 | Anne Marie Belinda | Nurse Practitioner | 1049 Main St., Springfield, MA 01103 | 2014-08-15 |
| 1538575295 | Sunrise Behavioral Health Clinic, LLC | Clinic/Center | 95 Frank B. Murray Street, Springfield, MA 01103 | 2014-07-02 |
| 1548675093 | Jessica Lynn Pasalacqua | Dietitian, Registered | 870 Main St., Springfield, MA 01103 | 2014-06-24 |
| 1003220443 | Ivan Rosario | Counselor | 1695 Main St Ste400, Springfield, MA 01103 | 2014-06-13 |
| 1275964769 | Leeandrew Rick Wilson | Counselor | 1695 Main St., Springfield, MA 01103 | 2013-12-09 |
| Find all providers in zip 01103 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
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|---|---|---|---|---|
| 1225174089 | Arnold Surgery Center | Clinic/Center | 1011 E Montclair St, Springfield, MO 65807-5075 | 2007-01-29 |
| 1912963810 | Springfield Surgery Center Lp | Clinic/Center | 2685 E High St, Springfield, OH 45505-1412 | 2006-04-21 |
| 1073588448 | Surgery Center of Springfield | Clinic/Center | 1350 E Woodhurst Dr, Springfield, MO 65804-4281 | 2006-02-21 |
| 1760457204 | Orthopaedic Surgery Center of Illinois, LLC | Clinic/Center | 3136 Old Jacksonville Rd, Suite 250, Springfield, IL 62704-6487 | 2006-02-20 |
| 1427028919 | Cascade Endoscopy Center, LLC | Clinic/Center | 1007 Harlow Road, Suite 110, Springfield, OR 97477 | 2006-01-25 |
| 1205810553 | Orthopaedic Asc of Springfield LLC | Clinic/Center | 3045 S National Ave, Suite 101, Springfield, MO 65804-4247 | 2005-11-30 |
| 1578551594 | Mercy Surgery Center, Ltd | Clinic/Center | 2610 N Limestone St, Springfield, OH 45503-1114 | 2005-10-13 |
| 1366449910 | Oregon Endoscopy Center, LLC | Clinic/Center | 3355 Riverbend Dr, Suite 510, Springfield, OR 97477-8800 | 2005-06-28 |
| 1588667208 | Bradford Place Surgery and Laser Center LLC | Clinic/Center | 1531 E Bradford Pkwy, Ste 120, Springfield, MO 65804-6539 | 2005-05-27 |
| 1295738375 | Oregon Surgicenter LLC | Clinic/Center | 2400 Hartman Ln, Ste 300, Springfield, OR 97477-1198 | 2005-05-23 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 01103 |
Please comment or provide details below to improve the information on LIBERTY STREET FACILITY.
| 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.