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Organization

LIBERTY SQUARE CARE CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE ZIMBELMAN (PRESIDENT)
(816) 232-9573
Entity
Organization

Contact information

Practice address
111 SOUTH BOULDER, NORA SPRINGS, IA 50458
(641) 792-5680
(641) 792-2630
Mailing address
111 SOUTH BOULDER, NORA SPRINGS, IA 50458
(641) 792-5680
(641) 792-2630

Taxonomy

Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
340777
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0232447
IA
05
0448449
IA
05
0894063
IA
Enumeration date
04/12/2006
Last updated
08/22/2020
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