Basic Information
| Provider Information | |||||||||
| NPI: | 1154457927 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LIBERTY WEST NURSING CENTER OF TOLEDO INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7445 LIBERTY WOODS LN | ||||||||
| Address2: | |||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454593911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372961550 | ||||||||
| FaxNumber: | 9372961540 | ||||||||
| Practice Location | |||||||||
| Address1: | 2051 COLLINGWOOD BLVD | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436201649 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192435191 | ||||||||
| FaxNumber: | 4192430316 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BLACK-KUREK | ||||||||
| AuthorizedOfficialFirstName: | LINDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9372961550 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 1437 | OH | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.