Organization
SOUTH BEND RESIDENTIAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN BERCHMANS NITUNGA (CEO)
(207) 312-2620
Entity
Organization
Contact information
Practice address
1602 N BROOKFIELD ST, SOUTH BEND, IN 46628-3008
(207) 312-2620
Mailing address
1602 N BROOKFIELD ST, SOUTH BEND, IN 46628-3008
(207) 312-2620
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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