National Provider Identifier Database

ICR ADOLESCENTS OPERATING SUBSIDIARY LLC
Adolescent and Children Mental Health

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.


Contact Information

ICR ADOLESCENTS OPERATING SUBSIDIARY, LLC
215 W 4TH ST
MISHAWAKA, IN46544-1917
Phone: 574-544-0207
Fax:
Website:
Specialty Taxonomy Code
* Adolescent and Children Mental Health 261QM0855X
Rehabilitation, Substance Use Disorder 261QR0405X
Substance Abuse Treatment, Children 3245S0500X

* Indicates primary specialty

NPI Profile & details for ICR ADOLESCENTS OPERATING SUBSIDIARY, LLC

NPI Number 1932058369
Legal business name
LBN
ICR ADOLESCENTS OPERATING SUBSIDIARY, LLC
Authorized official TARA GURNEY - (AUTHORIZED OFFICIAL)
Entity Organization
Organization subpart No
Enumeration date 01/27/2026
Last updated 05/28/2026 - About 2 weeks ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for ICR ADOLESCENTS OPERATING SUBSIDIARY, LLC

There are currently no reviews for ICR ADOLESCENTS OPERATING SUBSIDIARY, LLC


NPIdb - Home
v2.201