Organization
LIBERTY PUBLIC HEALTH
Active
Other names
LPH
Organization subpart
No
Provider details
NPI number
Authorized official
GARIS PIERRE EDDINGTON (CEO)
(267) 403-6677
Entity
Organization
Contact information
Practice address
1608 CHATTIN RD, LAVEROCK, PA 19038-7120
(267) 403-6677
Mailing address
1608 CHATTIN RD, LAVEROCK, PA 19038-7120
(267) 403-6677
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103295914
—
PA
Enumeration date
12/22/2017
Last updated
12/22/2017
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