Organization
ERAJ HOLDINGS, LLC
Active
Other names
Liberty Home Care, Liberty Home Care V, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD BENJAMIN MCNEILL (MANAGER)
(910) 815-3122
Entity
Organization
Contact information
Practice address
797 WOODLAND DR STE 103, STUART, VA 24171-5132
(276) 755-4766
(276) 755-4225
Mailing address
2334 S 41ST ST, WILMINGTON, NC 28403-5502
(910) 815-3122
(991) 081-5311
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007CH
BLUE CROSS BLUE SHIELD
VA
05
—
4907475
—
VA
01
—
497475
MEDICARE
VA
Enumeration date
05/06/2009
Last updated
06/16/2018
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