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MARY GRAN NURSING CENTER
NPI 1053454306
Assisted Living Facility in Clinton, NC

Active since February 15, 2007CLIA 34D0655364 · Waiver
120 SOUTHWOOD DR, CLINTON, NC 28328(910) 592-7981(910) 592-1864 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mary Gran Nursing Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY GRAN NURSING CENTER (NPI 1053454306) is a healthcare organization registered as an assisted living facility in Clinton, North Carolina and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Joe Calcutt, Cfo, as its authorized official.

NPPES Registry Identity

NPI1053454306
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameLIBERTY HEALTHCARE GROUP LLC
Location Address120 SOUTHWOOD DRClinton, NC 28328-5002
Mailing Address2334 S 41st StWilmington, NC 28403-5502 · (910) 815-3122 · Fax (910) 642-8537
Phone(910) 592-7981
Fax(910) 592-1864
Organization SubpartNo
Authorized OfficialJoe CalcuttCfo · (910) 815-1793
Enumeration DateFebruary 15, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1053454306 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in NC · NH0089
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
120 SOUTHWOOD DR, Clinton, NC 28328
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Other Names 1

Doing Business AsMary Gran Nursing Center

Other Identifiers 1

Medicaid7803731NC

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D0655364

Mary Gran Nursing Center · Clinton, NC
Active · expires Aug 31, 2026
CLIA Number34D0655364
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorMaryilynn Spell
Laboratory Phone(910) 592-7981
Laboratory LocationMary Gran Nursing Center120 Southwood Drive, Clinton, NC 28328
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JANICE AUSTRIA
Physical Therapist
120 SOUTHWOOD DR
CLINTON, NC 28328
Sampson County (910) 299-3681
LIBERTY HEALTHCARE GROUP LLC
Skilled Nursing Facility
120 SOUTHWOOD DR
CLINTON, NC 28328
Sampson County (910) 592-7981
LIBERTY MEDICAL TRANSPORTATION, LLC
Non-emergency Medical Transport (VAN)
120 SOUTHWOOD DR
CLINTON, NC 28328
Sampson County (910) 815-3122
ROBERT ALLEN WILSON MD
Family Medicine
120 SOUTHWOOD DR
CLINTON, NC 28328
Sampson County (910) 592-7981
BETSY THORNTON RN
Registered Nurse
120 SOUTHWOOD DR
CLINTON, NC 28328
Sampson County (910) 592-7981

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Liberty Healthcare Group LLC's NPI number?

The NPI number for Liberty Healthcare Group LLC is 1053454306. It was assigned to this organization in the NPPES registry on February 15, 2007. The provider is doing business as Mary Gran Nursing Center.

Where is Liberty Healthcare Group LLC located?

Liberty Healthcare Group LLC is located at 120 Southwood Dr, Clinton, NC 28328. The listed phone number is (910) 592-7981.

What is Liberty Healthcare Group LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Liberty Healthcare Group LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D0655364) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Liberty Healthcare Group LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.