Organization
ICR SOUTH BEND OPERATING SUBSIDIARY, LLC
Active
Organization
ICR SOUTH BEND OPERATING SUBSIDIARY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA GURNEY (AUTHORIZED OFFICIAL)
(561) 517-3400
Entity
Organization
Contact information
Practice address
215 W 4TH ST, MISHAWAKA, IN 46544-1917
(574) 544-0207
Mailing address
2925 10TH AVE N, PALM SPRINGS, FL 33461-3000
(305) 361-9115
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
283Q00000X
Psychiatric Hospital
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
01/27/2026
Last updated
05/28/2026
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