Organization Active NPI

Elkhart Place Assisted Living LLC

  • Assisted Living Facility
  • Elkhart, IN
National Provider Identifier
1780497735
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
ELKHART PLACE ASSISTED LIVING LLC
Practice address
2024 County Road 24 Ofc
Elkhart, IN 46517-9607
Phone
(260) 740-3220
NPI assigned
Jan 31, 2025
Last updated
Jan 31, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Authorized official

Name
Sherri Berghoff
Title
Ceo
Phone
(260) 740-3220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU Primary

Addresses

Primary practice location

2024 County Road 24 Ofc
Elkhart, IN 46517-9607

Mailing address

5904 E State Blvd
Fort Wayne, IN 46815-7637
Phone (260) 740-3220

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D1069100Elkhart Place Assisted Living2024 County Road 24, Elkhart, IN 46517Certificate of waiverMay 28, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1738281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738281600000",
    "number": "1780497735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5904 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468157637",
            "telephone_number": "260-740-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 COUNTY ROAD 24 OFC",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465179607",
            "telephone_number": "260-740-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELKHART PLACE ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-31",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A",
        "authorized_official_last_name": "BERGHOFF",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-740-3220"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.