GAHC3 MISHAWAKA IN ALF TRS SUB, LLC (NPI# 1205216942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205216942 |
| Entity Type | Organization |
| Organization Name | GAHC3 MISHAWAKA IN ALF TRS SUB, LLC |
| Other Organization Name | TANGLEWOOD TRACE |
| Practice Address |
530 Tanglewood Ln Mishawaka IN 46545-2627 |
| Practice Telephone | 3173249563 |
| Mailing Telephone | 3173249563 |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2015-06-08 |
| Authorized Official Name | DANNY PROSKY (AUTHORIZED REPRESENTATIVE) |
| Authorized Official Telephone | 9492709200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Tanglewood Trace | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | GAHC3 MISHAWAKA IN ALF TRS SUB, LLC | 18191 Von Karman Ave, Ste 300, Irvine, CA 92612 |
| Street Address |
530 TANGLEWOOD LN |
| City | MISHAWAKA |
| State | IN |
| Zip Code | 46545-2627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497885610 | Rhonda M Wells | Occupational Therapy Assistant | 530 Tanglewood Ln, Mishawaka, IN 46545-2627 | 2007-03-06 |
| 1215439104 | Adalynn Danette Mccullough | Speech-Language Pathologist | 530 Tanglewood Ln, Mishawaka, IN 46545-2627 | 2018-03-06 |
| 1790293983 | Legacy Healthcare Services, Inc. | Occupational Therapist | 530 Tanglewood Ln, Mishawaka, IN 46545-2627 | 2018-01-22 |
| 1548780745 | Karen Mendoza | Speech-Language Pathologist | 530 Tanglewood Ln, Mishawaka, IN 46545-2627 | 2017-06-20 |
| 1154860286 | Margaret Webster | Physical Therapy Assistant | 530 Tanglewood Ln, Mishawaka, IN 46545-2627 | 2017-02-22 |
| 1861937682 | Ryan Harlacher | Occupational Therapy Assistant | 530 Tanglewood Ln, Mishawaka, IN 46545-2627 | 2017-01-03 |
| 1679018824 | Stephanie Walsh | Physical Therapist | 530 Tanglewood Ln, Mishawaka, IN 46545-2627 | 2016-12-27 |
| 1881013654 | Jean Wolff | Physical Therapist | 530 Tanglewood Ln, Mishawaka, IN 46545-2627 | 2014-04-09 |
| 1477834489 | Peter Meidell | Speech-Language Pathologist | 530 Tanglewood Ln, Mishawaka, IN 46545-2627 | 2011-09-02 |
| 1184904823 | Joseph F Guzzi | Physical Therapy Assistant | 530 Tanglewood Ln, Mishawaka, IN 46545-2627 | 2011-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649824103 | Senior Helpers | In Home Supportive Care | 230 Catalpa Drive Suite B, Mishawaka, IN 46545 | 2019-08-01 |
| 1093272114 | Candice Marie Greathouse | Physical Therapy Assistant | 3630 Hickory Road, Mishawaka, IN 46545 | 2019-02-25 |
| 1639662596 | Mishawaka Rcf Lp | Assisted Living Facility | 3630 Hickory Rd, Mishawaka, IN 46545 | 2018-06-14 |
| 1760907299 | Timothy John Howard | Emergency Medicine | 610 1/2 N Main Street, Apartment 1, Mishawaka, IN 46545 | 2017-08-05 |
| 1699203612 | Paridhie Vasudevan | Dentist | 6502 Grape Rd Ste 882, Mishawaka, IN 46545 | 2017-06-03 |
| 1780134650 | Ossip Optometry, PC | Optometrist | 5111 N. Main Street, Suite 200, Mishawaka, IN 46545 | 2016-10-04 |
| 1457730038 | Melissa Anne Douthit | Nurse Practitioner | 3665 Park Pl W Ste 300, Mishawaka, IN 46545 | 2015-05-28 |
| 1558759654 | Spine and Joint Associates of Plymouth, Inc | Chiropractor | 229 Red Coach, Suite 106, Mishawaka, IN 46545 | 2014-12-26 |
| 1609264795 | Spine and Joint Associates of Mishawaka, Inc | Chiropractor | 229 Red Coach Trail, Suite 106, Mishawaka, IN 46545 | 2014-12-26 |
| 1508260795 | Maribel Smith | Counselor | 2989 Heritage Ct, Mishawaka, IN 46545 | 2014-10-16 |
| Find all providers in zip 46545 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902429822 | Hellenic Senior Living of Mishawaka LLC | Assisted Living Facility | 1540 S. Logan Street, Mishawaka, IN 46544 | 2020-05-27 |
| 1639662596 | Mishawaka Rcf Lp | Assisted Living Facility | 3630 Hickory Rd, Mishawaka, IN 46545 | 2018-06-14 |
| 1578980561 | Community Development Corporation of Mishawaka | Assisted Living Facility | 500 Lincolnway E, Mishawaka, IN 46544-2266 | 2014-03-27 |
| 1922358837 | Hancock Regional Hospital | Assisted Living Facility | 60257 Bodnar Blvd, Mishawaka, IN 46544-9342 | 2012-09-18 |
| 1588968416 | Arv Assisted Living, Inc. | Assisted Living Facility | 530 Tanglewood Ln, Mishawaka, IN 46545-2627 | 2011-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437757747 | Auburn Senior Living LLC | Assisted Living Facility | 1675 W. 7th Street, Auburn, IN 46706-2530 | 2020-10-09 |
| 1740895390 | The Health and Hospital Corporation of Marion County | Assisted Living Facility | 2002 Heritage Park Dr, Fort Wayne, IN 46805-5806 | 2020-09-10 |
| 1841804192 | Saint Anne Home of The Diocese of Fort Wayne-south Bend | Assisted Living Facility | 25 Victory Noll Dr, Huntington, IN 46750-9111 | 2020-09-03 |
| 1407460959 | Residential Care X L.L.C. | Assisted Living Facility | 7133 Meadow Trl, Brownsburg, IN 46112-1388 | 2020-09-02 |
| 1598379042 | Residential Care Xi L.L.C. | Assisted Living Facility | 10410 Allisonville Rd, Fishers, IN 46038-2017 | 2020-09-02 |
| 1821615444 | Newburgh Assisted Living, LLC | Assisted Living Facility | 4211 Grimm Rd, Newburgh, IN 47630-9444 | 2020-06-30 |
| 1003431461 | Residential Care Xiii L.L.C. | Assisted Living Facility | 741 Park East Blvd, Lafayette, IN 47905-0797 | 2020-06-11 |
| 1659994200 | Lake Meadows Licensee LLC | Assisted Living Facility | 11570 E 126th Street, Fishers, IN 46037 | 2020-05-18 |
| 1730712886 | Cook Road Aal Lp | Assisted Living Facility | 3731 W Cook Rd, Fort Wayne, IN 46818-9403 | 2020-02-18 |
| 1194358119 | Ev Fw Limited Partnership | Assisted Living Facility | 12523 Auburn Rd, Fort Wayne, IN 46845-8797 | 2020-02-18 |
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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.