Organization
LIBERTY CARE LLC DBA SOVEREIGN CARE SERVICES
Active
Other names
Sovereign Care Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NATAYA COOK PMP (OWNER)
(317) 654-4609
Entity
Organization
Contact information
Practice address
9411 CARLYLE DR APT D, INDIANAPOLIS, IN 46240-3903
(317) 654-4609
Mailing address
3250A W 86TH ST # 1264, INDIANAPOLIS, IN 46268-3605
(317) 654-4609
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300079824
—
IN
Enumeration date
07/29/2020
Last updated
12/05/2024
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