Organization Name: | LIBERTY HEALTHCARE GROUP, LLC |
NPI Number: | 1255401667 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANTHONY J. ZIZZAMIA (PRESIDENT/EXECUTIVE DIRECTOR) |
Mailing Address: | 401 E 3rd St Siler City |
State: | NC US |
Postal Code: | 273443233 |
Phone Number: | 9108153122 |
Fax Number: | 9108153111 |
NPI Enumeration Date: | 11/09/2006 |
NPI Last Update Date: | 05/06/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | HOS3149 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |