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Dungarvin Indiana, Llc
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in South Bend, Indiana
NPI 1275743205

Dungarvin Indiana, Llc is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Mendota Heights, IN. Dungarvin Indiana, Llc practices in South Bend, IN. The NPI Number for Dungarvin Indiana, Llc is 1275743205 and holds a License No. (Indiana).

The current practice location address for Dungarvin Indiana, Llc is 3575 Moreau Ct Ste 200, South Bend, IN and can be reached out via phone at 574-245-5400 and via fax at 574-245-5440.

Location: 3575 Moreau Ct Ste 200, South Bend, IN, 55120-1032
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1275743205
Provider Name
Dungarvin Indiana, Llc
Credential
Provider Entity Type
Organization
Address
3575 Moreau Ct Ste 200, South Bend, IN, 55120-1032
Phone Number
574-245-5400
Fax Number
574-245-5440
Provider Enumeration Date
05/22/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100239960 05 IN
100245120 05 IN
100245230 05 IN
100244770 05 IN
100244780 05 IN
100239800 05 IN
100244830 05 IN
100244950 05 IN
100230070 05 IN
institution
Provider Business Practice Location Address Details
Address
3575 Moreau Ct Ste 200
City
South Bend
State
Indiana
Zip
46628-4387
Phone Number
574-245-5400
Fax Number
574-245-5440
person
Provider Business Mailing Address Details
Address
3575 Moreau Ct Ste 200
City
South Bend
State
Indiana
Zip
46628-4387
Phone Number
574-245-5400
Fax Number
574-245-5440
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
()
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
()
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
person
Provider's Taxonomy Details 3
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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