Organization
LIBERTY HEALTHCARE GROUP, LLC
Active
Other names
Liberty Home Care , LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY J. ZIZZAMIA JR. RN (PRESIDENT/EXECUTIVE DIRECTOR)
(910) 815-3122
Entity
Organization
Contact information
Practice address
208 BEAMAN ST, CLINTON, NC 28328-2906
(910) 592-8367
(910) 592-8360
Mailing address
2334 S 41ST ST, WILMINGTON, NC 28403-5502
(910) 815-3122
(910) 815-3111
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
HOS3054
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007A
BLUE CROSS BLUE SHIELD
NC
05
—
3411569
—
NC
Enumeration date
10/27/2006
Last updated
05/01/2013
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