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THE CHILDREN'S CAMPUS INC. NPI 1396915369


NPI Information

NPI: 1396915369
Provider Name: THE CHILDREN'S CAMPUS, INC.
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
1011 E WASHINGTON ST
SOUTH BEND, IN
ZIP 46617
Phone: (574) 280-2082
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THE CHILDREN'S CAMPUS, INC. is a community based residential treatment facility mental illness in South Bend, IN. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. THE CHILDREN'S CAMPUS, INC. NPI is 1396915369. The provider is registered as an organization entity type.

The provider's business location address is:

1011 E WASHINGTON ST
SOUTH BEND, IN
ZIP 46617-109
Phone: (574) 280-2082

The provider's authorized official is Kristin Ermeti .
The authorized official title is Executive Director and has the following contact phone number (574) 259-5667.

The enumeration date for this NPI number is 3/6/2008 and was last updated on 6/19/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320800000XCommunity Based Residential Treatment Facility, Mental Illness43714INDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1200473490MEDICAIDINDIANA

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: 4/28/2024

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