Organization
CAREGIVERS OF LIBERTY II
Active
Parent organization
CAREGIVERS OF LIBERTY I
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAREGIVERS OF LIBERTY I
Authorized official
MR. ERNEST ISHMEAL LACKEY (FINANCIAL MANAGER)
(336) 622-2348
Entity
Organization
Contact information
Practice address
125 E RALEIGH AVE, LIBERTY, NC 27298-3305
(336) 622-2348
Mailing address
125 E RALEIGH AVE, LIBERTY, NC 27298-3305
(336) 622-2348
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FCL-076-033
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804676
—
NC
Enumeration date
09/15/2010
Last updated
09/15/2010
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