Entity Summary
ID Number: 000791564    
Summary for:  NCMIC Diversified Health RPG Assn.
The exact name of the Foreign Non-Profit Corporation:   NCMIC Diversified Health RPG Assn.
Entity type:   Foreign Non-Profit Corporation
Identification Number: 000791564
Date of in Rhode Island:   07-09-2012 Effective Date:   07-09-2012
The location of the Principal Office:
         
Address: 14001 UNIVERSITY AVE
City or Town, State, Zip, Country: CLIVE,   IA   50325   USA
Agent Resigned:  N   Address Maintained:  Y  
The name and address of the Registered Agent:
         
Name: CORPORATION SERVICE COMPANY
Address: 222 JEFFERSON BOULEVARD, SUITE 200
City or Town, State, Zip, Country: WARWICK,   RI   02888   USA
The Officers and Directors of the Corporation:
TitleIndividual NameAddress
PRESIDENTDAVID SIEBERT 14001 UNIVERSITY AVE CLIVE, IA 50325 USA
TREASURERMATT GUSTAFSON 14001 UNIVERSITY AVE CLIVE, IA 50325 USA
SECRETARYMATT GUSTAFSON 14001 UNIVERSITY AVE CLIVE, IA 50325 USA
DIRECTORDAVID SIEBERT 14001 UNIVERSITY AVE CLIVE, IA 50325 USA
DIRECTORMATT GUSTAFSON 14001 UNIVERSITY AVE CLIVE, IA 50325 USA
DIRECTORMIKE MCCOY 14001 UNIVERSITY AVE CLIVE, IA 50325 USA
Purpose:
North American Industry Classification System Code(NAICS):
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Business Services Division |          Rhode Island Department of State