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Organization
LIBERTY HEALTHCARE GROUP, LLC
Active
Organization
LIBERTY HEALTHCARE GROUP, LLC
Active
Other names
Liberty Home Care, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY JOSEPH ZIZZAMAI JR. RN (PRESIDENT/EXECUTIVE DIRECTOR)
(910) 815-3122
Entity
Organization
Contact information
Practice address
1700 COUNTRY CLUB RD, JACKSONVILLE, NC 28546-6004
(910) 346-4800
(910) 346-5870
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
HC0316
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007A
BLUE CROSS BLUE SHIELD
NC
05
—
3417001
—
NC
Enumeration date
05/24/2006
Last updated
03/28/2013
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