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Organization
LIBERTY HEALTHCARE GROUP LLC
Active
Organization
LIBERTY HEALTHCARE GROUP LLC
Active
Other names
Cross Creek Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOE CALCUTT (CFO)
(910) 332-1793
Entity
Organization
Contact information
Practice address
1719 QUARTER ROAD, SWAN QUARTER, NC 27885
(252) 926-2143
(252) 926-2414
Mailing address
2334 SOUTH 41ST STREET, LIBERTY HEALTHCARE MANAGEMENT INC, WILMINGTON, NC 28403
(910) 332-1777
(910) 815-3114
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
NULL
314000000X
Skilled Nursing Facility
Primary
NH0515
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3435407
—
NC
05
—
343600E
—
NC
Enumeration date
05/20/2006
Last updated
01/06/2020
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