OrganizationActive
Icr Adolescents Operating Subsidiary, LLC
NPI 1932058369 · Adolescent and Children Mental Health Clinic/Center · Mishawaka, IN
Provider details
- NPI number
- 1932058369
- Entity type
- Organization
- Primary specialty
- Adolescent and Children Mental Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Tara Gurney, Authorized Official(561) 517-3400
Specialties & taxonomies
Ambulatory Health Care Facilities
Residential Treatment Facilities
Ambulatory Health Care Facilities
Practice location
215 W 4th St
Mishawaka, IN 46544-1917
Phone: (574) 544-0207
Approximate (ZIP-level) locationGet directions
Mailing address
2925 10th Ave N
Palm Springs, FL 33461-3000
Registry dates
- Enumerated
- 2026-01-27
- Last updated
- 2026-05-28
- Certified
- 2026-05-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.