Liberty Healthcare Group LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0089 Issued in NC

Legal business name

LIBERTY HEALTHCARE GROUP LLC

Doing business as

Mary Gran Nursing Center

Practice address

120 Southwood Drive
Clinton, NC 28329

Phone

(910) 592-7981

Fax

(910) 592-3538

NPI assigned

May 23, 2006

Last updated

Aug 10, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Joe Calcutt

Title

Cfo

Phone

(910) 332-1793

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Mary Gran Nursing Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720033475. Details of each certification follow.

• CCN 345218 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 345218

Legal name

LIBERTY HEALTHCARE GROUP LLC

Doing business as

LIBERTY HEALTHCARE SERVICES OF MARY GRAN NURSING CENTER, LLC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 1, 1981

Last certification

Aug 12, 2024

Beds

212

Ownership / control type

Corporation

Multi-facility organization

Liberty Health and Rehab

Organization structure

LLCProprietary

Incorporated

Aug 18, 1998 in NC

Enrollment address

120 Southwood Drive
Clinton, NC 28329-5002

Nursing home name

MARY GRAN NURSING CENTER

Affiliated entity

LIBERTY SENIOR LIVING

Listed as

Mary Gran Nursing CenterCCN 345218 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

2 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Oct 1, 1981

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

212101.3 residents per day on average

Chain

Liberty Senior Living37 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

1Fines totaling $68,172

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Liberty Healthcare Group LLC119 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Liberty Healthcare Group LLC

  dba Liberty Commons NRC of Alamance County

  • Skilled Nursing Facility
  • Burlington, NC
  • NPI 1629111364
  NPD tax ID
• Liberty Healthcare Group LLC

  dba Liberty Home Care , LLC

  • Community Based Hospice Care Agency
  • Supply, NC
  • NPI 1629156872
  NPD tax ID
• Liberty Healthcare Group LLC

  dba Liberty Commons Nursing and Rehabilitation Center of Johnston County

  • Skilled Nursing Facility
  • Benson, NC
  • NPI 1669425401
  NPD tax ID
• Liberty Healthcare Group LLC

  dba Liberty Commons NRC of Rowan County

  • Skilled Nursing Facility
  • Salisbury, NC
  • NPI 1710021779
  NPD tax ID
• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Fayetteville, NC
  • NPI 1730817776
  NPD tax ID
• Liberty Healthcare Group LLC

  dba Liberty Commons Nursing and Rehabilitation Center of Lee County

  • Skilled Nursing Facility
  • Sanford, NC
  • NPI 1861446338
  NPD tax ID
• Liberty Healthcare Group, LLC

  dba Liberty Home Care, LLC

  • Case Management Agency
  • Wilmington, NC
  • NPI 1629217856
  NPD tax ID
• Liberty Healthcare Group, LLC

  • Skilled Nursing Facility
  • Blowing Rock, NC
  • NPI 1629535455
  NPD tax ID
• Liberty Healthcare Group, LLC

  dba Liberty Home Care II, LLC

  • Home Health Agency
  • Southern Pines, NC
  • NPI 1679528814
  NPD tax ID
• Liberty Healthcare Group, LLC

  dba Liberty Home Care II, LLC

  • Home Health Agency
  • Sanford, NC
  • NPI 1699721324
  NPD tax ID
• Liberty Healthcare Group, LLC

  dba Liberty Home Care, LLC

  • Community Based Hospice Care Agency
  • Lumberton, NC
  • NPI 1700956752
  NPD tax ID
• Liberty Healthcare Group, LLC

  dba Summerstone Health and Rehabilitation Center

  • Skilled Nursing Facility
  • Kernersville, NC
  • NPI 1710244827
  NPD tax ID

All disclosed owners & managing parties 15

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

Owners & managing parties with NPI records 1

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

• Robert Allen Wilson, MD

  • Family Medicine Physician
  • Clinton, NC
  • NPI 1629189279

  Adp of the SNF

  CMS ownership

All facility ownership & control disclosures 28

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

Facilities with the same owner 26

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

• Liberty Commons Nursing and Rehabilitation Center of Highland

  dba Highland House Rehabilitation and Healthcare

  • Skilled Nursing Facility
  • Fayetteville, NC
  • NPI 1811611577

  John a McNeill Jr 2012 Irrv TR, Liberty Healthcare Group LLC, Liberty Long Term Care LLC, Ronald B. and Cynthia J. McNeill 2013 Irrevocable Trust

  CMS ownership
• Liberty Commons of Robeson County

  dba Woodhaven Nursing Center

  • Skilled Nursing Facility
  • Lumberton, NC
  • NPI 1053090092

  John a McNeill Jr 2012 Irrv TR, Liberty Long Term Care LLC, Ronald B. and Cynthia J. McNeill 2013 Irrevocable Trust

  CMS ownership
• Liberty Healthcare Group LLC

  dba Southwood Nursing and Retirement Center

  • Skilled Nursing Facility
  • Clinton, NC
  • NPI 1043263981

  John a McNeill Jr 2012 Irrv TR, Liberty Healthcare Group LLC, Liberty Long Term Care LLC, Ronald B. and Cynthia J. McNeill 2013 Irrevocable Trust

  CMS ownership
• Liberty Healthcare Group LLC

  dba Liberty Commons Nursing and Rehabilitation Center of Halifax County

  • Assisted Living Facility
  • Weldon, NC
  • NPI 1164476636

  Liberty Long Term Care LLC

  CMS ownership
• Liberty Healthcare Group LLC

  dba Capital Nursing and Rehabilitation Center

  • Skilled Nursing Facility
  • Raleigh, NC
  • NPI 1255385720

  Liberty Long Term Care LLC, Ronald B. and Cynthia J. McNeill 2013 Irrevocable Trust

  CMS ownership
• Liberty Healthcare Group LLC

  dba Liberty Commons Nursing and Rehabilitation Center of Alamance County

  • Skilled Nursing Facility
  • Burlington, NC
  • NPI 1326089616

  Liberty Long Term Care LLC

  CMS ownership
• Liberty Healthcare Group LLC

  dba Liberty Commons Nursing and Rehabilitation Center of Matthews, LLC

  • Skilled Nursing Facility
  • Matthews, NC
  • NPI 1336193754

  Liberty Long Term Care LLC, Ronald B. and Cynthia J. McNeill 2013 Irrevocable Trust

  CMS ownership
• Liberty Healthcare Group LLC

  dba Liberty Commons Nursing and Rehabilitation Center of Rowan County

  • Skilled Nursing Facility
  • Salisburg, NC
  • NPI 1407800972

  John a McNeill Jr 2012 Irrv TR, Liberty Healthcare Group LLC, Liberty Long Term Care LLC, Ronald B. and Cynthia J. McNeill 2013 Irrevocable Trust

  CMS ownership
• Liberty Healthcare Group LLC

  dba Liberty Commons Nursing and Rehabilitation Center of Johnston County

  • Skilled Nursing Facility
  • Benson, NC
  • NPI 1669425401

  Liberty Long Term Care LLC

  CMS ownership
• Liberty Healthcare Group LLC

  dba Liberty Commons Nursing and Rehabilitation Center of Lee County

  • Skilled Nursing Facility
  • Sanford, NC
  • NPI 1861446338

  Liberty Long Term Care LLC

  CMS ownership
• Liberty Healthcare Group LLC

  dba Three Rivers Health and Rehabilitation Center

  • Skilled Nursing Facility
  • Windsor, NC
  • NPI 1881648350

  John a McNeill Jr 2012 Irrv TR, Liberty Healthcare Group LLC, Liberty Long Term Care LLC, Ronald B. and Cynthia J. McNeill 2013 Irrevocable Trust

  CMS ownership
• Liberty Healthcare Group LLC

  dba Westfield Rehabilitation and Health Center

  • Skilled Nursing Facility
  • Sanford, NC
  • NPI 1891740544

  Liberty Long Term Care LLC

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tracy E Ayers, MD

  • Family Medicine Physician
  • Morehead City, NC
  • NPI 1447203229
  NPD (past)
• Robert Allen Wilson, MD

  • Family Medicine Physician
  • Clinton, NC
  • NPI 1629189279
  NPD (past)

Affiliated clinicians 2

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

• Gajarah Baseemah Ballard Peterson, M.D.

  • Internal Medicine Physician
  • Wilmington, NC
  • NPI 1467626788

  Nursing home

  Care Compare affiliation
• Ken T. Yang, MD

  • Family Medicine Physician
  • Clinton, NC
  • NPI 1912935180

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1720033475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2334 SOUTH 41ST STREET",
            "address_2": "LIBERTY HEALTHCARE MANAGEMENT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28403",
            "telephone_number": "910-332-1777",
            "fax_number": "910-815-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SOUTHWOOD DRIVE",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "28329",
            "telephone_number": "910-592-7981",
            "fax_number": "910-592-3538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HEALTHCARE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "CALCUTT",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "910-332-1793",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "NH0089",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3415218",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3416093",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7803731",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary Gran Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mary Gran Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paige Lewis, MS, CCC/SLP
• Tracy Lewis, LCSW
• Liberty Healthcare Group LLC (Southwood Nursing and Retirement Center)
• Liberty Healthcare Group LLC (Mary Gran Nursing Center)
• Liberty Healthcare Group LLC (Mary Gran Nursing Center)
• Liberty Healthcare Group, LLC (Liberty Home Care , LLC)
• Liberty Medical Transportation, LLC
• Liberty Nursing Services,LLC (Liberty Nursing Services)
• Yvonne Linn
• Christopher Little, MD

• Skilled Nursing Facility in Clinton, NC
• Providers in Clinton, NC by specialty
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.