INDIANA CENTER FOR RECOVERY SOUTH BEND LLC NPI 1093664435

NPI Information

  • NPI: 1093664435
  • Provider Name: INDIANA CENTER FOR RECOVERY SOUTH BEND, LLC
  • Classification: Psychiatric Hospital - 283Q00000X
  • Entity Type: Organization
  • Address: 215 W 4TH ST
    MISHAWAKA, IN
    ZIP 46544
  • Phone: (305) 361-9115

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NPI Details

INDIANA CENTER FOR RECOVERY SOUTH BEND, LLC is a psychiatric hospital in Mishawaka, IN. The provider is an organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. INDIANA CENTER FOR RECOVERY SOUTH BEND, LLC NPI is 1093664435. The provider is registered as an organization entity type.

The provider's business location address is:

215 W 4TH ST
MISHAWAKA, IN
ZIP 46544-917
Phone: (305) 361-9115

The provider's authorized official is Daniel Moore .
The authorized official title is Authorized Official and has the following contact phone number (305) 361-9115.

The enumeration date for this NPI number is 1/27/2026 and was last updated on 1/27/2026.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0850XClinic/CenterAdult Mental HealthNo
2320800000XCommunity Based Residential Treatment Facility, Mental IllnessNo
3323P00000XPsychiatric Residential Treatment FacilityNo
4324500000XSubstance Abuse Rehabilitation FacilityNo
5283Q00000XPsychiatric HospitalYes

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: 11/21/2025

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