Organization
LIBERTY REHABILITATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYRONE JAMES BANKS MSOTR/L (OCCUPATIONAL THERAPIST)
(443) 621-4884
Entity
Organization
Contact information
Practice address
3333 NORTHMONT RD, WINDSOR MILL, MD 21244-2953
(443) 621-4884
Mailing address
3333 NORTHMONT RD, WINDSOR MILL, MD 21244-2953
(443) 621-4884
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
05877
MD
320700000X
Physical Disabilities Residential Treatment Facility
05877
MD
Other
Enumeration date
07/08/2008
Last updated
07/08/2008
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