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General NPI Number Information
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NPI Number | 1841801347
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Entity Type | Organization
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Legal Business Name | ELMWOOD OF FREMONT, LTD.
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Dates
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Enumeration Date | 08/10/2020
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Last Update Date | 08/10/2020
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Provider Practice Location Address
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Address Line | 1545 FANGBONER RD
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City | FREMONT
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State | OH
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Zip | 43420-1128
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Country | US
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Telephone | 419-332-6533
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Fax | 419-332-6535
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Provider Business Mailing Address
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Address Line | 441 N BROADWAY ST
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City | GREEN SPRINGS
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State | OH
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Zip | 44836-9689
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Country | US
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Telephone | 419-332-3378
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Fax | 419-639-2519
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | KATHY KAY HUNT
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Credential |
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Telephone | 419-332-3378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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