Organization
LIBERTY RESIDENTIAL CARE SERVICES
Active
Organization
LIBERTY RESIDENTIAL CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL L PAYNE (OWNER/DIRECTOR)
(614) 843-1696
Entity
Organization
Contact information
Practice address
2878 RAVENSWOOD CT, COLUMBUS, OH 43232-3830
(614) 843-1696
Mailing address
2878 RAVENSWOOD CT, COLUMBUS, OH 43232-3830
(614) 843-1696
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
05/11/2015
Last updated
05/11/2015
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