Organization
MISHAWAKA IL/AL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN LITT (SECRETARY / TREASURER)
(646) 844-3603
Entity
Organization
Contact information
Practice address
1025 PARK PL, MISHAWAKA, IN 46545-3528
(574) 247-1552
Mailing address
1025 PARK PL, MISHAWAKA, IN 46545-3528
(574) 247-1552
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/01/2024
Last updated
10/01/2024
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