9109 Liberty Road Operations LLC
NPI #1215234182 in Randallstown, Maryland
Provider Information
- NPI Number
- 1215234182
- Entity Type
- Organization
- Organization Name
- 9109 Liberty Road Operations LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Feb 11, 2011
- Last Updated
- Jan 8, 2016
Practice Location
- Address
- 9109 LIBERTY RD
- City
- Randallstown
- State
- Maryland
- ZIP Code
- 21133-3521
- Phone
- (410) 655-7373
Authorized Official
- Name
- MICHAEL T. BERG
- Title
- ASSISTANT SECRETARY
- Phone
- (505) 468-4752
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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