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Organization
LIBERTY NURSING CENTER OF FREMONT, INC
Active
Organization
LIBERTY NURSING CENTER OF FREMONT, INC
Active
Other names
Countryside Continuing Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA BLACK-KUREK (PRESIDENT)
(937) 296-1550
Entity
Organization
Contact information
Practice address
1865 COUNTRYSIDE DR, FREMONT, OH 43420-8748
(419) 334-2602
(419) 334-6287
Mailing address
7445 LIBERTY WOODS LN, DAYTON, OH 45459-3911
(419) 334-2602
(419) 334-6287
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
6160
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2303055
—
OH
Enumeration date
07/01/2006
Last updated
06/13/2013
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