Provider Demographics
NPI:1235988692
Name:LIBERTY PLACE INC
Entity type:Organization
Organization Name:LIBERTY PLACE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:HANSEN
Authorized Official - Last Name:GEIGER
Authorized Official - Suffix:
Authorized Official - Credentials:DIRECTOR CBIS
Authorized Official - Phone:406-287-3154
Mailing Address - Street 1:PO BOX 446
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:MT
Mailing Address - Zip Code:59759-0446
Mailing Address - Country:US
Mailing Address - Phone:406-287-3154
Mailing Address - Fax:406-287-3164
Practice Address - Street 1:313 W LEGION ST
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:MT
Practice Address - Zip Code:59759-7762
Practice Address - Country:US
Practice Address - Phone:406-287-3154
Practice Address - Fax:406-287-3164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)