Organization
DYCORA TRANSITIONAL HEALTH - MISHAWAKA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY HAWKINS (EXECUTIVE)
(574) 259-1917
Entity
Organization
Contact information
Practice address
811 E 12TH ST, MISHAWAKA, IN 46544-5408
(574) 259-1917
Mailing address
811 E 12TH ST, MISHAWAKA, IN 46544-5408
(574) 259-1917
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
IN
Other
Enumeration date
12/07/2016
Last updated
01/24/2018
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