LIBERTY HEALTHCARE GROUP LLC NPI 1255404059

NPI Information

NPI: 1255404059
Provider Name: LIBERTY HEALTHCARE GROUP, LLC

Doing Business As: LIBERTY HOME CARE, LLC

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

Address:
1830 OWEN DR
SUITE 103
FAYETTEVILLE, NC
ZIP 28304
Phone: (910) 864-8411
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LIBERTY HEALTHCARE GROUP, LLC is a hospice care community based in Fayetteville, NC. LIBERTY HEALTHCARE GROUP, LLC NPI is 1255404059. The provider is registered as an organization entity type.
The provider Is Doing Business As Liberty Home Care, Llc.

The provider's business location address is:

1830 OWEN DR
SUITE 103
FAYETTEVILLE, NC
ZIP 28304-611
Phone: (910) 864-8411
Fax: (910) 487-4429

The provider's authorized official is Anthony J. Zizzamia .
The authorized official title is President/executive Director and has the following contact phone number (910) 815-3122.

The CLIA number assigned to this NPI record is 34D0856179 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/17/2006 and was last updated on 12/14/2010.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based		HOS2004	NORTH CAROLINA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	007A	OTHER	NORTH CAROLINA	BLUE CROSS BLUE SHIELD
2	3411569	MEDICAID	NORTH CAROLINA
3	341569	MEDICARE ID-TYPE UNSPECIFIED	NORTH CAROLINA	PROVIDER NUMBER

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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