Provider Demographics
NPI:1154496750
Name:RESIDENTIAL CARE VI, LLC
Entity Type:Organization
Organization Name:RESIDENTIAL CARE VI, LLC
Other - Org Name:NORTHWOODS COMMONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:BURKHART
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:317-788-2500
Mailing Address - Street 1:2501 FRIENDSHIP BLVD
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46901-4199
Mailing Address - Country:US
Mailing Address - Phone:765-454-0001
Mailing Address - Fax:765-454-0003
Practice Address - Street 1:2501 FRIENDSHIP BLVD
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-4199
Practice Address - Country:US
Practice Address - Phone:765-454-0001
Practice Address - Fax:765-454-0003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility