# LIBERTY HEALTHCARE GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Liberty Commons NRC of Wake County
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194868679
- **Authorized official:** JOE CALCUTT (CFO)
- **Authorized official phone:** (910) 332-1793

## Contact information

- **Practice address:** 3000 HOLSTON LN, RALEIGH, NC 27610-2002
- **Practice address phone:** (919) 231-6045
- **Practice address fax:** (919) 231-0943
- **Mailing address:** 2334 S 41ST ST, WILMINGTON, NC 28403-5502
- **Mailing address phone:** (910) 815-3122
- **Mailing address fax:** (910) 642-8537

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH0268 | NC | Yes |

## Other

- **Enumeration date:** 02/15/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3446204 | — | NC |