NPIMap

Organization Active NPI

Eraj Holdings, LLC

Doing business as Liberty Home Care

  • Home Health Agency
  • Stuart, VA
National Provider Identifier
1124252184
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ERAJ HOLDINGS, LLC
Doing business as
Liberty Home Care
Liberty Home Care V, LLC
Practice address
797 Woodland Dr Ste 103
Stuart, VA 24171-5132
Phone
(276) 755-4766
Fax
(276) 755-4225
NPI assigned
May 6, 2009
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ronald Benjamin McNeill
Title
Manager
Phone
(910) 815-3122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

797 Woodland Dr Ste 103
Stuart, VA 24171-5132

Mailing address

2334 S 41St St
Wilmington, NC 28403-5502
Phone (910) 815-3122

Other identifiers 3

IdentifierTypeStateIssuer
4907475MedicaidVA
007CHOtherVABLUE CROSS BLUE SHIELD
497475OtherVAMEDICARE

Other names 2

  • Liberty Home Care Doing business as
  • Liberty Home Care V, LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190118002507 VA Part A Provider - Home Health Agency 9739246588 Practice locations: Stuart, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124252184. Details of each certification follow.

Home health agency certification: CCN 497475

Legal name
ERAJ HOLDINGS, LLC
Doing business as
LIBERTY HOME CARE V LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 16, 1994
Last certification
Jan 20, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Sep 19, 2008 in NC
Enrollment address
797 Woodlawn Drive
Suite 103
Stuart, VA 24171-3635

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Liberty Home Care V LLCCCN 497475 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Jun 16, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D0890687Liberty Home Care, LLC Dba Liberty Home Care797 Woodland Drive, Stuart, VA 24171Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Eraj Holdings LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

336 N South St
Mount Airy, NC 27030
Phone (336) 719-7434

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Home Care Management Services LLC Organization, Wilmington, NC LLC Operational/Managerial Control Oct 1, 2008
Holly Macdonald Individual Operational/Managerial ControlPresident of HH and Hospice Service Jul 1, 2019
John Albert McNeill Individual 5% Or Greater Direct Ownership Interest Oct 1, 2008
5% Or Greater Indirect Ownership Interest Oct 1, 2008
Donna Turlington Individual W-2 Managing EmployeePresident of Home Care and Ho Aug 1, 2023
Deborah S McNeill Individual 5% Or Greater Direct Ownership Interest Oct 1, 2008
5% Or Greater Indirect Ownership Interest Sep 25, 2018
Mary Hubbard Individual Operational/Managerial ControlHome Health Administrator Jul 22, 2023
Ronald Benjamin McNeill Individual 5% Or Greater Direct Ownership Interest Sep 25, 2018
Cynthia McNeill Individual 5% Or Greater Direct Ownership Interest Sep 28, 2018
5% Or Greater Indirect Ownership Interest Sep 28, 2018
Eraj Holdings, LLC Organization, Wilmington, NC LLC 5% Or Greater Direct Ownership Interest Sep 28, 2018
Operational/Managerial Control Sep 28, 2018

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Eraj Holdings, LLC

    dba Liberty Home Care V, LLC

    • Home Health Agency
    • Mount Airy, NC
    • NPI 1770717894

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Liberty Home Care V, LLCMount Airy, NC, CCN 347172 Home health agency 5% Or Greater Direct Ownership Interest Sep 28, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 19

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 19

Practitioners & affiliated clinicians

Affiliated clinicians 13

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1124252184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2334 S 41ST ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035502",
            "telephone_number": "910-815-3122",
            "fax_number": "991-081-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "797 WOODLAND DR STE 103",
            "city": "STUART",
            "state": "VA",
            "postal_code": "241715132",
            "telephone_number": "276-755-4766",
            "fax_number": "276-755-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERAJ HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-06",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "MCNEILL",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "910-815-3122"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4907475",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "007CH",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "497475",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Home Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Liberty Home Care V, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stuart, VA

Sources for this page

Verify at the official NPI Registry.