LIBERTY HEALTHCARE GROUP, LLC (NPI# 1669427951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669427951 |
| Entity Type | Organization |
| Organization Name | LIBERTY HEALTHCARE GROUP, LLC |
| Other Organization Name | LIBERTY HOME CARE, LLC |
| Practice Address |
1700 Country Club Rd Jacksonville NC 28546-6004 |
| Mailing Address |
2334 S 41st St Wilmington NC 28403-5502 |
| Practice Telephone | 9103464800 |
| Practice Fax Number | 9103465870 |
| Mailing Telephone | 9108153122 |
| Mailing Fax Number | 9108153111 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2013-03-28 |
| Authorized Official Name | MR. ANTHONY JOSEPH ZIZZAMAI JR. (PRESIDENT/EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9108153122 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | HC0316 | NC | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3417001 | 05 | |
| NC | BLUE CROSS BLUE SHIELD | 007A | 01 |
| Other Name | Type Code |
|---|---|
| Liberty Home Care, LLC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629535455 | Liberty Healthcare Group, LLC | Skilled Nursing Facility | 621 Chestnut Ridge Pkwy, Blowing Rock, NC 28605-8962 | 2019-02-28 |
| 1962832899 | Liberty Healthcare Group, LLC | Skilled Nursing Facility | 10011 Providence Rd W, Charlotte, NC 28277-1561 | 2013-11-13 |
| 1891908687 | Liberty Healthcare Group, LLC | Assisted Living Facility | 316 Nc Highway 801 S, Advance, NC 27006-7647 | 2007-05-08 |
| 1194894790 | Liberty Healthcare Group, LLC | Hospice Care, Community Based | 44 Mcneill Plz, Whiteville, NC 28472-8602 | 2006-11-07 |
| 1003995937 | Liberty Healthcare Group, LLC | Hospice Care, Community Based | 1206 Arendell Street, Morehead City, Nc 28557-4145, Morehead City, NC 28557-4145 | 2006-11-02 |
| 1801974555 | Liberty Healthcare Group, LLC | Hospice Care, Community Based | 501 Doctors Drive, Elizabethtown, NC 28337-3146 | 2006-11-01 |
| 1730267105 | Liberty Healthcare Group, LLC | Hospice Care, Community Based | 1005 Carthage Street, Sanford, NC 27331-0066 | 2006-11-01 |
| 1851477418 | Liberty Healthcare Group, LLC | Hospice Care, Community Based | 208 Beaman St, Clinton, NC 28328-2906 | 2006-10-27 |
| 1083790638 | Liberty Healthcare Group, LLC | Hospice Care, Community Based | 2563 Eric Ln Ste F, Burlington, NC 27215-4302 | 2006-10-27 |
| 1912920174 | Liberty Healthcare Group, LLC | Alzheimer Center (Dementia Center) | 3045 Henderson Dr, Jacksonville, NC 28546-5247 | 2006-07-26 |
| Street Address |
1700 COUNTRY CLUB RD |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-6004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164557369 | Liberty Nursing Services, LLC | Nursing Care | 1700 Country Club Rd, Jacksonville, NC 28546-6004 | 2007-02-21 |
| 1104995745 | Liberty Healthcare Group LLC | Hospice Care, Community Based | 1700 Country Club Rd, Jacksonville, NC 28546-6004 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447850185 | Latoya Butler | Home Health | 5710 Lenox Ave Apt 121, Jacksonville, FL 32205-6383 | 2020-10-30 |
| 1871193334 | All Executive Healthcare Agency LLC | Home Health | 841 Prudential Dr Ste 1211, Jacksonville, FL 32207-8329 | 2020-10-26 |
| 1013516335 | Melissa Horne | Home Health | 2426 Lotus Rd E, Jacksonville, FL 32211-4169 | 2020-10-19 |
| 1114525821 | Sep Companion Services | Home Health | 1979 Lane Ave S, Jacksonville, FL 32210-2741 | 2020-10-14 |
| 1235737925 | Concierge Home Care of Jacksonville 2, LLC | Home Health | 4655 Salisbury Rd Ste 110, Jacksonville, FL 32256-0957 | 2020-10-14 |
| 1821696808 | Above and Beyond Solutions LLC | Home Health | 8030 Loch Lomond Ln, Jacksonville, FL 32244-5519 | 2020-10-13 |
| 1891302386 | Deanna Domineck | Home Health | 913 Lord Nelson Blvd, Jacksonville, FL 32218-6755 | 2020-09-28 |
| 1861009359 | A Serene Services LLC | Home Health | 8553 Argyle Business Loop Ste 5e, Jacksonville, FL 32244-6604 | 2020-09-28 |
| 1770199317 | Alpha 1st Home Health Care | Home Health | 1619 Nottingham Knoll Dr, Jacksonville, FL 32225-2665 | 2020-09-18 |
| 1255944682 | Life Assistance and Management Agency | Home Health | 7606 Tarleton Rd, Jacksonville, FL 32208-3433 | 2020-08-25 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
Please comment or provide details below to improve the information on LIBERTY HEALTHCARE GROUP, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.