NPIMap

Organization Active NPI

SNH Indy Tenant LLC

  • Assisted Living Facility
  • Kokomo, IN
National Provider Identifier
1215666367
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
SNH INDY TENANT LLC
Practice address
603 Saint Joseph Dr
Kokomo, IN 46901-4189
Phone
(765) 868-3000
Fax
(765) 868-3084
NPI assigned
Jun 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Richard W. Siedel Jr.
Title
Cfo & Treasurer
Phone
(617) 796-8350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

603 Saint Joseph Dr
Kokomo, IN 46901-4189

Mailing address

603 Saint Joseph Dr
Kokomo, IN 46901-4189
Phone (765) 868-3000

Other names 1

  • Jefferson Manor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
SNH Indy Tenant LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654473600000",
    "number": "1215666367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 SAINT JOSEPH DR",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469014189",
            "telephone_number": "765-868-3000",
            "fax_number": "765-868-3084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 SAINT JOSEPH DR",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469014189",
            "telephone_number": "765-868-3000",
            "fax_number": "765-868-3084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNH INDY TENANT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-06",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A",
        "authorized_official_last_name": "SIEDEL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CFO & TREASURER",
        "authorized_official_telephone_number": "617-796-8350",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.