KGC Operator, Inc.
Organization Active NPI Assisted Living Facility · Vernon, TX
NPI 1710043906 · NPPES record last updated Jun 13, 2008
Key facts
- NPI
- 1710043906
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- Legal business name
- KGC OPERATOR, INC.
- Practice address
- 4501 College Dr
Vernon, TX 76384-4093 - Phone
- (940) 552-8181
- NPI assigned
- Dec 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Mark Ohlendorf
- Title
- Co-President
- Phone
- (414) 918-5000
Corporate family (same tax ID) 5
National Provider Directory
- Tax ID family
- Alterra Clare Bridge Cottage of SW Oklahoma City
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Yes |
Addresses
Primary practice location
4501 College Dr
Vernon, TX 76384-4093
Mailing address
6737 W Washington St
Suite 2300
Milwaukee, WI 53214-5647
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001004636 | Medicaid | TX |
Other names
- Wynwood of Vernon
Other providers in Vernon, TX
- Alexander M. Kalmanov
- Hannah Karr
- Jennifer Kauer
- Vera Marie Kemp
- Kevin Lane DO PA
- Kimberly Horn
- Jill Marie King
- Kenneth J Kohutek
- Kevin B Lane
- Lee B. Harrison, D.D.S., P.C.
All providers in Vernon, TX · Assisted Living Facility in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.