LIFE TREATMENT CENTERS (NPI# 1437444692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437444692 |
| Entity Type | Organization |
| Organization Name | LIFE TREATMENT CENTERS |
| Practice Address |
1402 S Michigan St South Bend IN 46613-2214 |
| Practice Telephone | 5742335433 |
| Practice Fax Number | 5742396407 |
| Mailing Telephone | 5742335433 |
| Mailing Fax Number | 5742396407 |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2011-06-16 |
| Authorized Official Name | MR. DAVID NOWAK (CEO) |
| Authorized Official Telephone | 5742335433 |
| Authorized Official Credential | MSBA,MBA,PHR |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 806-0-ASR | IN | Residential Treatment Facilities |
| Street Address |
1402 S MICHIGAN ST |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46613-2214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881120798 | Shakira Desavoir | Counselor | 1402 S Michigan St, South Bend, IN 46613-2214 | 2017-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730330721 | Mindy Lynne Gradeless | Social Worker | 229 East Ewing Avenue, South Bend, IN 46613 | 2008-10-08 |
| 1689836405 | Staci-marie Balog Norman | Pharmacist | 760 West Cotter Street, South Bend, IN 46613 | 2008-07-02 |
| 1659386779 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1945 Lincolnway East, South Bend, IN 46613 | 2006-07-29 |
| 1003026642 | Logan Community Resources, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2105 Wabash St, South Bend, IN 46613-1138 | 2007-05-23 |
| 1366702060 | Clara M Davis | Private Vehicle | 1719 W Dubail St, South Bend, IN 46613-1216 | 2012-05-29 |
| 1215923313 | Gregory Matthew Ferro | Family Medicine | 1832 Prairie Ave, South Bend, IN 46613-1400 | 2005-09-23 |
| 1508330002 | Homeworks Construction Inc | Durable Medical Equipment & Medical Supplies | 1511 Pulaski St, South Bend, IN 46613-1404 | 2019-01-17 |
| 1477763415 | Logan Community Resources, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1917 S Walnut St, South Bend, IN 46613-1541 | 2007-05-22 |
| 1013117472 | Ronald E Grow Inc | Family Medicine | 810 W Indiana Ave, South Bend, IN 46613-1828 | 2007-07-23 |
| 1932296290 | Carol L. Vaughn | Nurse Practitioner | 1733 S Michigan St, South Bend, IN 46613-2219 | 2006-10-06 |
| Find all providers in zip 46613 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912303736 | Choices Recovery | Substance Abuse Rehabilitation Facility | 3606 E Jefferson Blvd, South Bend, IN 46615-3052 | 2014-11-05 |
| 1922438928 | Ywca North Central Indiana | Substance Abuse Rehabilitation Facility | 1102 Fellows St, South Bend, IN 46601-3514 | 2013-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607597 | Momentum Kokomo, LLC | Substance Abuse Rehabilitation Facility | 1236 N. Wabash Ave, Kokomo, IN 46901 | 2020-10-23 |
| 1992304836 | Oasis Recovery, LLC | Substance Abuse Rehabilitation Facility | 2155 N 100 E, Tipton, IN 46072-8490 | 2020-10-21 |
| 1699302356 | Evolve Indy LLC | Substance Abuse Rehabilitation Facility | 8770 Guion Rd Ste B, Indianapolis, IN 46268-3017 | 2020-03-24 |
| 1366082091 | Celtic Recovery, LLC | Substance Abuse Rehabilitation Facility | 5660 Madison Ave, Indianapolis, IN 46227-4671 | 2020-01-10 |
| 1508408378 | Allendale LLC | Substance Abuse Rehabilitation Facility | 5419 County Road 427, Auburn, IN 46706-9504 | 2019-10-14 |
| 1154979615 | Pax Riverbend LLC | Substance Abuse Rehabilitation Facility | 1403 Spring St Ste 1, Jeffersonville, IN 47130-3736 | 2019-08-28 |
| 1578121547 | Landmark Recovery of Carmel, LLC | Substance Abuse Rehabilitation Facility | 13594 N Meridian St, Carmel, IN 46032-1698 | 2019-06-04 |
| 1881157329 | Grace Recovery and Wellness LLC | Substance Abuse Rehabilitation Facility | 3320 Main St Ste D, Anderson, IN 46013-4267 | 2019-04-11 |
| 1679035232 | Summit Bhc Henryvillle | Substance Abuse Rehabilitation Facility | 2602 Hebron Church Rd, Henryville, IN 47126-9021 | 2019-04-03 |
| 1457819195 | The Breakaway Corp | Substance Abuse Rehabilitation Facility | 1514 E Spring St, New Albany, IN 47150-2844 | 2019-03-12 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46613 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.