| NPI | 1154414035 |
|---|---|
| Doing Business As | LIBERTY COMMUNITY SUPPORT CENTER |
| Entity Type | Organization |
| Authorized Contact | WILLIAM H. COLLETT Administrator 225-766-2262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |