Provider Demographics
NPI:1700037926
Name:FREMONT CARE CENTER INC
Entity Type:Organization
Organization Name:FREMONT CARE CENTER INC
Other - Org Name:NYE LEGACY HEALTH & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
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 1:3210 NORTH CLARKSON
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025
Mailing Address - Country:US
Mailing Address - Phone:402-721-9300
Mailing Address - Fax:402-753-4800
Practice Address - Street 1:3210 NORTH CLARKSON
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025
Practice Address - Country:US
Practice Address - Phone:402-721-9330
Practice Address - Fax:402-753-4800
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FREMONT CARE CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-07
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE285278Medicare Oscar/Certification
NE285287Medicare Oscar/Certification