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Organization
LIBERATION HOUSE LLC
Active
Organization
LIBERATION HOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELVIN CLARK III (OWNER/CEO)
(561) 901-5525
Entity
Organization
Contact information
Practice address
417 SW 9TH ST, DELRAY BEACH, FL 33444-2331
(561) 901-5525
Mailing address
2501 OCEANVIEW AVE, DELRAY BEACH, FL 33444-4373
(561) 901-5525
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/02/2015
Last updated
04/02/2015
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