| NPI | 1679978134 |
|---|---|
| Doing Business As | PROVIDEND PLACE OF FREMONT |
| Entity Type | Organization |
| Authorized Contact | JASON LANGE Manager 402-960-0376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311500000X Alzheimer Center (Dementia Center) (Licence: NE ALF349) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2014-10-27 |