Organization
LIBERTY HEALTHCARE GROUP LLC
Active
Other names
Liberty Commons Nursing and Rehabilitation Center of Columbus County
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOE CALCUTT (CFO)
(910) 332-1793
Entity
Organization
Contact information
Practice address
1402 PINCKNEY STREET, WHITEVILLE, NC 28472
(910) 642-4245
(910) 642-7187
Mailing address
2334 SOUTH 41ST STREET, LIBERTY HEALTHCARE MANAGEMENT INC, WILMINGTON, NC 28403
(910) 642-0224
(910) 815-3114
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
—
—
314000000X
Skilled Nursing Facility
Primary
NH0283
NC
335E00000X
Prosthetic/Orthotic Supplier
NH0283
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00951
BCBS
NC
05
—
3415207
—
NC
05
—
3416217
—
NC
Enumeration date
05/20/2006
Last updated
01/27/2023
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