LIBERTY VILLAGE
NPI 1750790960
Assisted Living Facility in Chillicothe, OH

NPI Status: Active since August 13, 2014

Contact Information

1839 WESTERN AVE
CHILLICOTHE, OH
ZIP 45601
Phone: (740) 773-4630
Fax: (740) 773-4648

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 36D2286819
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 08-02-2025

About LIBERTY VILLAGE

This page provides the complete NPI Profile along with additional information for Liberty Village, a provider established in Chillicothe, Ohio operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1750790960 assigned on August 2014. The practitioner's primary taxonomy code is 310400000X with license number 2020 RCF (OH). The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Liberty Village. The authorized official of this NPI record is Mr. J Michael Haemmerle (President)

NPI
1750790960
Provider Legal Name
LIBERTY VILLAGE SENIOR COMMUNITIES INC
Other Organization Name
LIBERTY VILLAGE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1839 WESTERN AVE CHILLICOTHE, OH 45601
Location Phone
(740) 773-4630
Location Fax
(740) 773-4648
Mailing Address
5920 VENTURE DRIVE DUBLIN, OH 43017
Mailing Phone
(614) 798-5110
Mailing Fax
(740) 773-4648
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-13-2014
Last Update Date
06-07-2023
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
License No.
2020 RCF
License State
OH
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. J MICHAEL HAEMMERLE

Authorized Official Title
PRESIDENT
Authorized Official Phone
(614) 799-4447

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
385459727MEDICAID (05)OH 
2020 RCFOTHER (01)OHRCF LICENSE

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
36D2286819
Facility Type
Assisted Living Facility
Certificate Effective Date
August 03, 2023
Certificate Expiration Date
August 02, 2025
Laboratory Director
SHEILA J. BLEVINS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Liberty Village to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for LIBERTY VILLAGE

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1750790960
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
271001490912
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 0 + 0 + 1 + 4 + 9 + 0 + 9 + 1 + 2 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1750790960 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1750790960, enumerated in the NPI registry as an "organization" on August 13, 2014

The provider is located at 1839 Western Ave Chillicothe, Oh 45601 and the phone number is (740) 773-4630

This medical organization specializes in Assisted Living Facility with taxonomy code 310400000X

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 36D2286819 for a "assisted living facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on August 13, 2014. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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