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General NPI Number Information
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NPI Number | 1881724342
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Entity Type | Organization
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Legal Business Name | FREMONT REST CENTER
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 06/25/2013
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Provider Practice Location Address
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Address Line | 300 SOUTH STREET
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City | FREMONT
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State | NC
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Zip | 27830
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Country | US
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Telephone | 919-242-6161
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Fax | 919-242-5187
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Provider Business Mailing Address
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Address Line | PO BOX 878
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City | OAK RIDGE
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State | NC
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Zip | 27310-0878
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Country | US
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Telephone | 336-643-0555
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Fax | 336-643-0553
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MRS. JACKIE PIERCE
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Credential |
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Telephone | 336-643-0555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | HAL-096-024
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | HAL-096-024
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License Number State | NC
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