Organization
LIBERTY MANOR RESIDENCY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA ROXAS LPN (PRESIDENT)
(602) 524-8124
Entity
Organization
Contact information
Practice address
17632 N 5TH PL, PHOENIX, AZ 85022-1809
(602) 441-2563
(602) 354-7129
Mailing address
6501 E GREENWAY PKWY, SUITE 103, PMB 505, SCOTTSDALE, AZ 85254-2065
(602) 441-2563
(602) 354-7129
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
ALH-4580
AZ
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
ALH-4580
AZ
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
ALH-4580
AZ
Other
Enumeration date
10/04/2006
Last updated
09/11/2025
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