Organization
LIBERTY HEALTHCARE GROUP LLC
Active
Other names
Southwood Nursing and Retirement Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOE CALCUTT (CFO)
(910) 332-1793
Entity
Organization
Contact information
Practice address
180 SOUTHWOOD DRIVE, CLINTON, NC 28329
(910) 592-8165
(910) 596-2253
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
314000000X
Skilled Nursing Facility
Primary
NH0571
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00991
BCBS
NC
05
—
3415472
—
NC
05
—
341609Z
—
NC
Enumeration date
05/19/2006
Last updated
08/22/2020
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