LIBERTY HEALTHCARE GROUP LLC NPI 1053454306

NPI Information

NPI: 1053454306
Provider Name: LIBERTY HEALTHCARE GROUP LLC

Doing Business As: MARY GRAN NURSING CENTER

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
120 SOUTHWOOD DR
CLINTON, NC
ZIP 28328
Phone: (910) 592-7981
Get Directions

LIBERTY HEALTHCARE GROUP LLC is an assisted living facility in Clinton, NC. The provider is 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. LIBERTY HEALTHCARE GROUP LLC NPI is 1053454306. The provider is registered as an organization entity type.
The provider Is Doing Business As Mary Gran Nursing Center.

The provider's business location address is:

120 SOUTHWOOD DR
CLINTON, NC
ZIP 28328-002
Phone: (910) 592-7981
Fax: (910) 592-1864

The provider's authorized official is Joe Calcutt .
The authorized official title is Cfo and has the following contact phone number (910) 815-1793.

The enumeration date for this NPI number is 2/15/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility		NH0089	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7803731	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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