Organization
LIBERTAE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE BASTEK KARASOW M.S.W. (EXECUTIVE DIRECTOR)
(215) 639-8681
Entity
Organization
Contact information
Practice address
5245 BENSALEM BLVD, BENSALEM, PA 19020-4076
(215) 639-8681
(215) 639-4277
Mailing address
5245 BENSALEM BLVD, BENSALEM, PA 19020-4076
(215) 639-8681
(215) 639-4277
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
093149
PA
251S00000X
Community/Behavioral Health Agency
097074
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001627736
—
PA
05
—
0016277360001
—
PA
Enumeration date
04/19/2007
Last updated
04/09/2009
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