Provider Demographics
NPI:1205821832
Name:T.W.G. NURSING HOME, INC.
Entity type:Organization
Organization Name:T.W.G. NURSING HOME, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:TWAROG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-724-8288
Mailing Address - Street 1:511 N WESTERN
Mailing Address - Street 2:P.O. BOX 66
Mailing Address - City:GIRARD
Mailing Address - State:KS
Mailing Address - Zip Code:66743
Mailing Address - Country:US
Mailing Address - Phone:620-724-8288
Mailing Address - Fax:620-724-4713
Practice Address - Street 1:511 N WESTERN
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:KS
Practice Address - Zip Code:66743
Practice Address - Country:US
Practice Address - Phone:620-724-8288
Practice Address - Fax:620-724-4713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1497OtherBLUE CROSS BLUE SHIELD
KS1041531501Medicaid
KS1041531501Medicaid