CORVILLA INC. (NPI# 1265553606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265553606 |
| Entity Type | Organization |
| Organization Name | CORVILLA INC. |
| Practice Address |
18443 Bulla Rd South Bend IN 46637-5426 |
| Mailing Address |
3231 Sugar Maple Business Ct South Bend IN 46628-4372 |
| Practice Telephone | 5742778129 |
| Mailing Telephone | 5742899779 |
| Mailing Fax Number | 5742890185 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. JULIE A LUCKY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5742899779 |
| Authorized Official Credential | MPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | IN | Residential Treatment Facilities |
| Street Address |
18443 BULLA RD |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46637-5426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851715155 | Rachel Cundiff | Pharmacist | 52482 Sr 933 N, South Bend, IN 46637 | 2014-02-07 |
| 1821427857 | Hancock Regional Hospital | Skilled Nursing Facility | 52565 Sr 933, South Bend, IN 46637 | 2013-11-12 |
| 1437587854 | Triple L Associates | Durable Medical Equipment & Medical Supplies | 227 Dixie Way North, Suite 110, South Bend, IN 46637 | 2013-10-22 |
| 1104251479 | Tao Bai | Pharmacist | 52482 State Rd 933, South Bend, IN 46637 | 2013-09-05 |
| 1801152210 | Richard James Holloway | Urology | 18799 Arapaho Ln, South Bend, IN 46637 | 2012-04-10 |
| 1255613618 | Angela Taylor | Pharmacist | 52482 St Rd 933 N, South Bend, IN 46637 | 2011-09-12 |
| 1831345248 | Cherlyn Po | Occupational Therapist | 52654 N Ironwood Rd, South Bend, IN 46637 | 2008-08-18 |
| 1164599304 | Decatur County Memorial Hospital | Alzheimer Center (Dementia Center) | 18325 Bailey Ave, South Bend, IN 46637 | 2006-11-30 |
| 1831572478 | Patrick Kelly | Occupational Therapy Assistant | 52565 Sr 933, South Bend, IN 46637 | 2015-07-01 |
| 1083262992 | Francesca E Udoh | Nurse Practitioner | 51875 Whitestable Ln, South Bend, IN 46637-1371 | 2019-09-04 |
| Find all providers in zip 46637 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346691177 | Miami Homecare Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1912 Miami St, South Bend, IN 46613-2915 | 2016-06-22 |
| 1497965222 | Logan Community Resources, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 119 Spruce St, South Bend, IN 46616-1129 | 2007-05-23 |
| 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 |
| 1912117557 | Logan Community Resources, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3031 Bentley Ln, South Bend, IN 46615-3607 | 2007-05-23 |
| 1841400488 | Logan Community Resources, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1325 Brentwood Ct, South Bend, IN 46628-1326 | 2007-05-23 |
| 1316157126 | Logan Community Resources, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2804 Corpus Christi Dr, South Bend, IN 46628-3430 | 2007-05-23 |
| 1154531184 | Logan Community Resources, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 20089 Lark Dr, South Bend, IN 46637-3023 | 2007-05-22 |
| 1164632105 | Logan Community Resources, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1602 Orkney Dr, South Bend, IN 46614-3562 | 2007-05-22 |
| 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 |
| 1477643286 | Partners In Opportunities, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6101 Nimtz Pkwy, South Bend, IN 46628-6111 | 2006-10-13 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46637 |
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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.