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Contact Information

INDIANA CENTER FOR RECOVERY ADOLESCENT PROGRAM LLC
215 W 4TH ST
MISHAWAKA, IN46544-1917
 Phone: 561-305-0461
 Fax:
 Website:
Indicates primary specialty

NPI Profile & details for INDIANA CENTER FOR RECOVERY ADOLESCENT PROGRAM LLC

NPI Number 1457196735
LBN Legal business name INDIANA CENTER FOR RECOVERY ADOLESCENT PROGRAM LLC
Authorized official KIRILL VESSELOV - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/27/2024
Last updated 01/14/2026 - About 5 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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