Organization
LIBERTY LEASING CO., LLC
Active
Other names
BridgePark Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER CAMPBELL (DIRECTOR OF REIMBURSEMENTS)
(513) 489-7100
Entity
Organization
Contact information
Practice address
4017 LIBERTY HEIGHTS AVE, BALTIMORE, MD 21207-7545
(410) 542-5306
Mailing address
4700 ASHWOOD DR, SUITE 200, CINCINNATI, OH 45241-2465
(513) 489-7100
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
414432500
—
MD
Enumeration date
01/30/2008
Last updated
09/27/2016
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