# LIBERTY HEALTHCARE GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Liberty Commons Nsg & Rehab Ctr of Ballantyne
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962832899
- **Authorized official:** PENNY TERESA PURIFOY (EXECUTIVE FINANCIAL CONSULTANT)
- **Authorized official phone:** (910) 642-0224

## Contact information

- **Practice address:** 10011 PROVIDENCE RD W, CHARLOTTE, NC 28277-1561
- **Practice address phone:** (980) 245-8500
- **Mailing address:** 2334 41ST ST, WILMINGTON, NC 28403-5502
- **Mailing address phone:** (910) 815-3122
- **Mailing address fax:** (910) 815-3111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 11/13/2013
- **Last updated:** 02/15/2024