Organization
COMMUNITY DEVELOPMENT CORP OF MISHAWAKA, INDIANA
Active
Other names
Vannoni Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MITCHELL FRANK CRAVEN (ADMINISTRATOR)
(574) 855-3937
Entity
Organization
Contact information
Practice address
500 LINCOLN WAY EAST, MISHAWAKA, IN 46544-2266
(574) 855-3937
(574) 855-3510
Mailing address
500 LINCOLN WAY EAST, MISHAWAKA, IN 46544-2266
(574) 855-3937
(574) 855-3510
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
12-012688-2
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220126881
—
IN
Enumeration date
03/27/2014
Last updated
07/16/2024
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