Organization
LIBERTY HEALTHCARE SYSTEMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RADIAN HENNIGAN (CFO)
(318) 251-9458
Entity
Organization
Contact information
Practice address
4673 EUGENE WARE BLVD, BASTROP, LA 71220-1425
(318) 281-2448
(318) 281-2499
Mailing address
4673 EUGENE WARE BLVD, BASTROP, LA 71220-1425
(318) 281-2448
(318) 281-2499
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
573
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1453676
—
LA
Enumeration date
05/29/2007
Last updated
08/22/2020
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