Organization
INDIANA CENTER FOR RECOVERY SOUTH BEND, LLC
Active
Other names
Hoosier Wellness Providers
Organization subpart
No
Provider details
NPI number
Authorized official
KIRILL VESSELOV (CEO)
(561) 305-0461
Entity
Organization
Contact information
Practice address
215 W 4TH ST, MISHAWAKA, IN 46544-1917
(561) 305-0461
Mailing address
2925 10TH AVE N, PALM SPRINGS, FL 33461-3000
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
01/21/2022
Last updated
09/02/2025
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