MARY GRAN NURSING CENTER – NPI #1720033475
Skilled Nursing Facility

(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.

MARY GRAN NURSING CENTER is a skilled nursing facility (SNF) located in CLINTON, NC. NPPES has assigned the NPI number 1720033475 to MARY GRAN NURSING CENTER on May 23, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “MARY GRAN NURSING CENTER” is a dba name, the actual legal business name for this organization is LIBERTY HEALTHCARE GROUP LLC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 314000000X from the Health Care Provider Taxonomy code set, which is classified as Skilled Nursing Facility.

The NPI profile was previously updated about 5 years ago on Aug 10, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MARY GRAN NURSING CENTER below.

NPI Profile for
LIBERTY HEALTHCARE GROUP LLC

NPI Number
1720033475
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LIBERTY HEALTHCARE GROUP LLC
Doing Business As (dba): MARY GRAN NURSING CENTER
Primary location
120 SOUTHWOOD DRIVE
CLINTON, NC 28329
Phone: (910) 592-7981 Fax: (910) 592-3538
Mailing address
2334 SOUTH 41ST STREET
LIBERTY HEALTHCARE MANAGEMENT
WILMINGTON, NC 28403
Phone: (910) 332-1777 Fax: (910) 815-3114
Organization Subpart
No
Authorized Official
JOE CALCUTT
CFO
Phone: (910) 332-1793
Updated
Certification Date
Aug 10, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for MARY GRAN NURSING CENTER

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDNC3416093
MEDICAIDNC7803731
MEDICAIDNC3415218
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
314000000X
- Skilled Nursing Facility (Primary)
NC NH0089
310400000X
- Assisted Living Facility
NC NH0089

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.