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LIBERTY HEALTHCARE GROUP LLC NPI 1164476636


NPI Information

NPI: 1164476636
Provider Name: LIBERTY HEALTHCARE GROUP LLC

Doing Business As: LIBERTY COMMONS NURSING AND REHABILITATION CENTER OF HALIFAX COUNTY

Classification: Skilled Nursing Facility - 314000000X
Entity Type: Organization
Address:
101 CAROLINE AVENUE
WELDON, NC
ZIP 27890
Phone: (252) 536-4817
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LIBERTY HEALTHCARE GROUP LLC is a skilled nursing facility in Weldon, NC. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. LIBERTY HEALTHCARE GROUP LLC NPI is 1164476636. The provider is registered as an organization entity type.
The provider Is Doing Business As Liberty Commons Nursing And Rehabilitation Center Of Halifax County.

The provider's business location address is:

101 CAROLINE AVENUE
WELDON, NC
ZIP 27890-432
Phone: (252) 536-4817
Fax: (252) 536-5560

The provider's authorized official is Joe Calcutt .
The authorized official title is Cfo and has the following contact phone number (910) 332-1793.

The enumeration date for this NPI number is 5/20/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1314000000XSkilled Nursing FacilityNH0469NORTH CAROLINAYes
2310400000XAssisted Living FacilityX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13415309MEDICAIDNORTH CAROLINA
23416501MEDICAIDNORTH CAROLINA
37805732MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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