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Organization

LIBERTY HEALTHCARE GROUP, LLC

Active
Other names
Liberty Home Care II, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ANTHONY J. ZIZZAMIA JR. RN (PRESIDENT)
(910) 815-3122
Entity
Organization

Contact information

Practice address
601 S KINGS DR, SUITE JJ, CHARLOTTE, NC 28204-2932
(704) 940-8389
(704) 940-8598
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
HC3694
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007CH
BLUE CROSS BLUE SHIELD
NC
05
3407242
NC
Enumeration date
08/14/2007
Last updated
04/02/2013
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