Organization
LIBERTY HEALTHCARE GROUP LLC
Active
Other names
Mary Gran Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOE CALCUTT (CFO)
(910) 815-1793
Entity
Organization
Contact information
Practice address
120 SOUTHWOOD DR, CLINTON, NC 28328-5002
(910) 592-7981
(910) 592-1864
Mailing address
2334 S 41ST ST, WILMINGTON, NC 28403-5502
(910) 815-3122
(910) 642-8537
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
NH0089
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7803731
—
NC
Enumeration date
02/15/2007
Last updated
08/22/2020
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