Provider Demographics
NPI:1639372139
Name:VELMA DOWDY RCF II
Entity Type:Organization
Organization Name:VELMA DOWDY RCF II
Other - Org Name:FREMONT CARE CENTER INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER BILLING
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:DEANN
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-251-3555
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:MO
Mailing Address - Zip Code:63941-0278
Mailing Address - Country:US
Mailing Address - Phone:573-251-3555
Mailing Address - Fax:573-251-2589
Practice Address - Street 1:HWY 60 EAST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:MO
Practice Address - Zip Code:63941-0278
Practice Address - Country:US
Practice Address - Phone:573-251-3555
Practice Address - Fax:573-251-2589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO032109310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility