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Contact Information

LIBERTY HEALTHCARE GROUP LLC
120 SOUTHWOOD DRIVE
CLINTON, NC28329
 Phone: 910-592-7981
 Fax: 910-592-3538
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Assisted Living Facility

310400000X
Indicates primary specialty

NPI Profile & details for LIBERTY HEALTHCARE GROUP LLC

NPI Number 1720033475
LBN Legal business name LIBERTY HEALTHCARE GROUP LLC
Authorized official JOE CALCUTT - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 05/23/2006
Last updated 08/10/2021 - About 5 years ago
Identifiers
NC License # NH0089
NC Medicaid 3415218
NC Medicaid 3416093
NC Medicaid 7803731
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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