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LIBERTY CARE LLC
NPI 1902641038
Assisted Living Facility in Coon Rapids, MN

Active since June 29, 2024CLIA 24D2317252 · Waiver
10820 DIRECT RIVER DR NW, COON RAPIDS, MN 55433(651) 354-9760 Get Directions Write a Review

NPPES record last updated: July 2, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 2, 2024, Jun 29, 2024 (2 updates tracked since 2024).

About Liberty Care Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIBERTY CARE LLC (NPI 1902641038) is a healthcare organization registered as an assisted living facility in Coon Rapids, Minnesota and active in the NPI registry since June 2024. The organization holds a CLIA Waiver certificate valid through January 20, 2027 and lists Omowunmi Mariam Bayo, Owner, as its authorized official.

NPPES Registry Identity

NPI1902641038
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameLIBERTY CARE LLC
Location Address10820 DIRECT RIVER DR NWCoon Rapids, MN 55433-3923
Mailing Address1480 Park St Apt 215White Bear Lake, MN 55110-3795 · (651) 354-9760
Phone(651) 354-9760
Organization SubpartNo
Authorized OfficialOmowunmi Mariam BayoOwner · (651) 354-9760
Enumeration DateJune 29, 2024
Last NPPES UpdateJuly 2, 20242 updates tracked since enumeration
NPPES CertifiedJuly 2, 2024
✔ NPI 1902641038 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
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.
10820 DIRECT RIVER DR NW, Coon Rapids, MN 55433
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Other Names 1

Doing Business AsLiberty Care Llc

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2317252

Liberty Care LLC · Coon Rapids, MN
Active · expires Jan 20, 2027
CLIA Number24D2317252
Laboratory TypeAssisted Living Facility
Certificate Effective DateJanuary 21, 2025
Certificate Expiration DateJanuary 20, 2027
Laboratory DirectorOmowunmi Bayo
Laboratory Phone(651) 354-9760
Laboratory LocationLiberty Care LLC10820 Direct River Dr NW, Coon Rapids, MN 55433
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Liberty Care LLC's NPI number?

The NPI number for Liberty Care LLC is 1902641038. It was assigned to this organization in the NPPES registry on June 29, 2024.

Where is Liberty Care LLC located?

Liberty Care LLC is located at 10820 Direct River Dr NW, Coon Rapids, MN 55433. The listed phone number is (651) 354-9760.

What is Liberty Care LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Liberty Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2317252) is associated with this NPI, valid through January 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Liberty Care LLC was last updated on July 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.