NPIMap

Organization Active NPI

Liberty Corner Enterprises, Inc.

  • Community/Behavioral Health Agency
  • Clyde, NC
National Provider Identifier
1245615087
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LIBERTY CORNER ENTERPRISES, INC.
Practice address
211 Nellie John Dr
Clyde, NC 28721-7006
Phone
(828) 627-1997
NPI assigned
Jul 22, 2015
Last updated
Feb 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Authorized official

Name
Mrs. Greta Byrd, MBA
Title
Executive Director
Phone
(828) 254-9917

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Developmentally Disabled Services Day Training Agency 251C00000X NU
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X NU
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU
Durable Medical Equipment & Medical Supplies 332B00000X NU
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

211 Nellie John Dr
Clyde, NC 28721-7006

Mailing address

119 Tunnel Rd. Suite 120a
Asheville, NC 28805-1107
Phone (828) 254-9917

Other identifiers 4

IdentifierTypeStateIssuer
5950430MedicaidNC
8301154MedicaidNC
3408614MedicaidNC
7804737MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Liberty Corner Enterprises Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612396800000",
    "number": "1245615087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 TUNNEL RD. SUITE 120A",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288051107",
            "telephone_number": "828-254-9917",
            "fax_number": "828-251-5373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 NELLIE JOHN DR",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287217006",
            "telephone_number": "828-627-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY CORNER ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-22",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A",
        "authorized_official_last_name": "BYRD",
        "authorized_official_first_name": "GRETA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "828-254-9917",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5950430",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301154",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408614",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804737",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clyde, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.