Provider Demographics
NPI:1245772227
Name:LWG CORP
Entity Type:Organization
Organization Name:LWG CORP
Other - Org Name:CARING SENIOR SERVICE OF FOX CITIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:GLASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-570-6509
Mailing Address - Street 1:3215 W LAWRENCE ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-4274
Mailing Address - Country:US
Mailing Address - Phone:920-570-6509
Mailing Address - Fax:920-570-6510
Practice Address - Street 1:3215 W LAWRENCE ST
Practice Address - Street 2:SUITE 7
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-4274
Practice Address - Country:US
Practice Address - Phone:920-570-6509
Practice Address - Fax:920-570-6510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care