Provider Demographics
NPI:1164419339
Name:WESTY COMMUNITY CARE HOME, INC
Entity Type:Organization
Organization Name:WESTY COMMUNITY CARE HOME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HUPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-457-2801
Mailing Address - Street 1:105 N HIGHWAY 99
Mailing Address - Street 2:
Mailing Address - City:WESTMORELAND
Mailing Address - State:KS
Mailing Address - Zip Code:66549-9695
Mailing Address - Country:US
Mailing Address - Phone:785-457-2801
Mailing Address - Fax:785-457-2130
Practice Address - Street 1:105 N HIGHWAY 99
Practice Address - Street 2:
Practice Address - City:WESTMORELAND
Practice Address - State:KS
Practice Address - Zip Code:66549-9695
Practice Address - Country:US
Practice Address - Phone:785-457-2801
Practice Address - Fax:785-457-2130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-04
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN075005314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS175471Medicare Oscar/Certification