Provider Demographics
NPI:1346232295
Name:FREMONT CARE CENTER, INC.
Entity Type:Organization
Organization Name:FREMONT CARE CENTER, INC.
Other - Org Name:NYE POINTE HEALTH AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:HARNISCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-753-6101
Mailing Address - Street 1:2700 LAVERNA ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-2410
Mailing Address - Country:US
Mailing Address - Phone:402-727-4900
Mailing Address - Fax:402-727-8163
Practice Address - Street 1:2700 N LAVERNA ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025
Practice Address - Country:US
Practice Address - Phone:402-727-4900
Practice Address - Fax:402-727-8163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE254003314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========-00Medicaid
NE=========-00Medicaid