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Organization
LIBERTY HEALTHCARE GROUP, LLC
Active
Organization
LIBERTY HEALTHCARE GROUP, LLC
Active
Other names
Liberty Home Care II, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD BENJAMIN MCNEILL (MANAGER)
(910) 815-3122
Entity
Organization
Contact information
Practice address
336 S MAIN ST, RAEFORD, NC 28376-3221
(910) 875-8198
(910) 875-8862
Mailing address
2334 S 41ST ST, WILMINGTON, NC 28403-5502
(910) 815-3122
(910) 815-3111
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC0277
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007CH
BLUE CROSS BLUE SHIELD
NC
05
—
3427024
—
NC
Enumeration date
05/24/2006
Last updated
02/02/2009
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