LIBERTY HEALTHCARE GROUP LLC
Alzheimer Center
Whiteville, North Carolina
Provider NPI: 1538113014
Organization Information:Organization Name: LIBERTY HEALTHCARE GROUP LLC
Practice Location:
1402 PINCKNEY STREET WHITEVILLE, NC 28472 US
Tel: 910-642-4245 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
1402 PINCKNEY STREET WHITEVILLE, NC 28472 US
Tel: 910-642-4245 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 311500000X | Nursing & Custodial Care Facilities Alzheimer Center (Dementia Center) | ||
N | 335E00000X | Suppliers Prosthetic/Orthotic Supplier | NC | NH0283 |
Y | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility | NC | NH0283 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
3415207 | NC | 05 | |
3416217 | NC | 05 | |
BCBS | 00951 | NC | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin