MICHIANA MENTAL HEALTH CARE, LLC. (NPI# 1205315033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205315033 |
| Entity Type | Organization |
| Organization Name | MICHIANA MENTAL HEALTH CARE, LLC. |
| Practice Address |
210 S Race St Mishawaka IN 46544 |
| Mailing Address |
14691 Copper Penny Dr Granger IN 46530-8304 |
| Practice Telephone | 5742207084 |
| Mailing Telephone | 5742207084 |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2018-08-22 |
| Authorized Official Name | TARA STANTON (OWNER) |
| Authorized Official Telephone | 5742207084 |
| Authorized Official Credential | NP-P |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
71016282A | IN | Nursing & Custodial Care Facilities |
| N | 310500000X | Intermediate Care Facility, Mental Illness | 71016282A | IN | Nursing & Custodial Care Facilities |
| N | 314000000X | Skilled Nursing Facility | 71016282A | IN | Nursing & Custodial Care Facilities |
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
71006282A | IN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 1194175554 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 14691 Copper Penny Dr, Granger, IN 465308304 | 5742207084 |
| Street Address |
210 S RACE ST |
| City | MISHAWAKA |
| State | IN |
| Zip Code | 46544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700867058 | Joyce M Mcmahon Palmateer | Registered Nurse | 210 S Race St, Mishawaka, IN 46544-2032 | 2005-11-11 |
| 1679182208 | Choose Joy Counseling Services LLC | Social Worker | 210 S Race St, Mishawaka, IN 46544-2032 | 2020-07-29 |
| 1861049595 | Melina Marie Sample | Psychologist | 210 S Race St, Mishawaka, IN 46544-2032 | 2019-08-19 |
| 1750862959 | Michiana Neuroscience, LLC | Clinical Neuropsychologist | 210 S Race St, Mishawaka, IN 46544-2032 | 2018-08-24 |
| 1649624735 | Michael Richard Mitcheff | Clinical Neuropsychologist | 210 S Race St, Mishawaka, IN 46544-2032 | 2016-04-15 |
| 1669491338 | James Robert Davis II | Dentist | 210 S Race St, Mishawaka, IN 46544-2032 | 2006-07-19 |
| 1104892371 | Rebecca L Allen-legault | Nurse Practitioner | 210 S Race St, Mishawaka, IN 46544-2032 | 2006-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692676 | Lynnette Markowicz | Occupational Therapist | 1540 S. Logan St, Mishawaka, IN 46544 | 2020-09-08 |
| 1902429822 | Hellenic Senior Living of Mishawaka LLC | Assisted Living Facility | 1540 S. Logan Street, Mishawaka, IN 46544 | 2020-05-27 |
| 1184275422 | Lorrajean A Gleva | Technician | 203 Eastgate Circle, Mishawaka, IN 46544 | 2019-09-27 |
| 1376072785 | Aims, LLC | Psychologist | 1113 Mossy Lane, Mishawaka, IN 46544 | 2017-06-08 |
| 1760835912 | Ophelia Ansari | Nurse Practitioner | 4501 Linconway East, Mishawaka, IN 46544 | 2016-07-22 |
| 1598153355 | Hearing Aid Service | Hearing Instrument Specialist | 3718 Lincolnway E, Mishawaka, IN 46544 | 2015-01-02 |
| 1437587953 | Christopher Ryan Hazel | Dentist | 544 Lincolnway West, Mishawaka, IN 46544 | 2013-10-18 |
| 1699015941 | Frank Walerko | Urology | 809 Bittersweet Cove Drive, Mishawaka, IN 46544 | 2013-02-25 |
| 1023251337 | Josephine Schimizzi | Family Medicine | 1505 South Spring Street, Mishawaka, IN 46544 | 2009-04-16 |
| 1881831147 | Walgreen Co | Pharmacy | 4620 Lincolnway E, Mishawaka, IN 46544 | 2009-01-08 |
| Find all providers in zip 46544 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649346339 | Specialized Alternatives for Families and Youth of Indiana, Inc. | Clinic/Center | 2410 Grape Rd, Suite 6, Mishawaka, IN 46545-3015 | 2006-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922605864 | Connected In Community, LLC | Clinic/Center | 5625 N German Church Rd Ste 105, Indianapolis, IN 46235-8513 | 2020-10-05 |
| 1932713054 | Ana Mental Health Counseling, LLC | Clinic/Center | 10831 Snowdrop Way, Indianapolis, IN 46235-3561 | 2020-09-04 |
| 1679182174 | Southern Indiana Therapeutics, LLC | Clinic/Center | 2819 Engle Rd, Starlight, IN 47106-8423 | 2020-07-30 |
| 1285251421 | Circle City Iop LLC | Clinic/Center | 6202 Carrollton Ave, Indianapolis, IN 46220-1925 | 2020-07-04 |
| 1023658382 | Vision Wealth Group | Clinic/Center | 3333 N Illinois St Ste 14, Indianapolis, IN 46208-4682 | 2020-01-14 |
| 1659928794 | Original Housing Program | Clinic/Center | 3539 N College Ave # 1, Indianapolis, IN 46205-3755 | 2019-08-22 |
| 1669938957 | Restoration Counseling Center LLC | Clinic/Center | 120 Nw 5th St, Richmond, IN 47374-4119 | 2019-02-12 |
| 1467929554 | Connections Counseling Services LLC | Clinic/Center | 17150 Mcerlain St, South Bend, IN 46635-1756 | 2018-10-27 |
| 1194218024 | Gilead House, Inc. | Clinic/Center | 406 E Sycamore St, Kokomo, IN 46901-4825 | 2018-06-14 |
| 1700382892 | Sayre Counseling Services, LLC | Clinic/Center | 1311 W 96th St Ste 105, Indianapolis, IN 46260-1173 | 2018-04-05 |
| Find all providers with the same taxonomy | ||||
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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.