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KOKOMO BG OPCO LLC NPI 1760937312


NPI Information

NPI: 1760937312
Provider Name: KOKOMO BG OPCO LLC

Doing Business As: KOKOMO PLACE

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 15D0977601

Address:
3025 W SYCAMORE ST
KOKOMO, IN
ZIP 46901
Phone: (765) 456-1490
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KOKOMO BG OPCO LLC is an assisted living facility in Kokomo, IN. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. KOKOMO BG OPCO LLC NPI is 1760937312. The provider is registered as an organization entity type.
The provider Is Doing Business As Kokomo Place.

The provider's business location address is:

3025 W SYCAMORE ST
KOKOMO, IN
ZIP 46901-176
Phone: (765) 456-1490

The provider's authorized official is Peter Tarsney .
The authorized official title is Authorized Signatory and has the following contact phone number (312) 725-7000.

The CLIA number assigned to this NPI record is 15D0977601 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/23/2016 and was last updated on 10/20/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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