# LIBERTY STREET FACILITY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902963705
- **Authorized official:** DAVID M CHADBOURNE MD (OWNER)
- **Authorized official phone:** (413) 746-4800

## Contact information

- **Practice address:** 125 LIBERTY ST, SUITE 206, SPRINGFIELD, MA 01103-1114
- **Practice address phone:** (413) 746-4800
- **Mailing address:** 125 LIBERTY ST, SUITE 206, SPRINGFIELD, MA 01103-1114
- **Mailing address phone:** (413) 746-4800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 59098 | MA | Yes |

## Other

- **Enumeration date:** 01/02/2007
- **Last updated:** 08/22/2020