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Organization

LIBERTY LODGE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RHONDA PATRICK (DIRECTOR)
(713) 397-9098
Entity
Organization

Contact information

Practice address
160 FM 2507, ALICE, TX 78332-7763
(361) 664-7555
Mailing address
PO BOX 3915, ALICE, TX 78333-3915
(361) 664-7555

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
03/03/2020
Last updated
01/24/2023
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