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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