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LIBERTY HEALTHCARE GROUP LLC NPI 1912920174


NPI Information

NPI: 1912920174
Provider Name: LIBERTY HEALTHCARE GROUP, LLC

Doing Business As: LIBERTY COMMONS NURSING AND REHABILITATION CENTER OF ONSLOW COUNTY, LL

Classification: Alzheimer Center (Dementia Center) - 311500000X
Entity Type: Organization

CLIA Number: 34D2193719

Address:
3045 HENDERSON DR
JACKSONVILLE, NC
ZIP 28546
Phone: (910) 355-1996
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LIBERTY HEALTHCARE GROUP, LLC is an alzheimer center dementia center in Jacksonville, NC. The provider is a freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer's Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations. LIBERTY HEALTHCARE GROUP, LLC NPI is 1912920174. The provider is registered as an organization entity type.
The provider Is Doing Business As Liberty Commons Nursing And Rehabilitation Center Of Onslow County, Ll.

The provider's business location address is:

3045 HENDERSON DR
JACKSONVILLE, NC
ZIP 28546-247
Phone: (910) 355-1996
Fax: (910) 455-7665

The provider's authorized official is Joe Calcutt .
The authorized official title is Cfo and has the following contact phone number (910) 815-3122.

The CLIA number assigned to this NPI record is 34D2193719 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/26/2006 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
1311500000XAlzheimer Center (Dementia Center)Yes
2310400000XAssisted Living FacilityX

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
17803924MEDICAIDNORTH 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

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