Organization
LIBERTY CARE LLC
Active
Other names
Liberty Care LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MISS OMOWUNMI MARIAM BAYO PROVIDER (OWNER)
(651) 354-9760
Entity
Organization
Contact information
Practice address
10820 DIRECT RIVER DR NW, COON RAPIDS, MN 55433-3923
(651) 354-9760
Mailing address
1480 PARK ST APT 215, WHITE BEAR LAKE, MN 55110-3795
(651) 354-9760
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
06/29/2024
Last updated
07/02/2024
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