NPIMap

Organization Active NPI

Dungarvin Indiana, LLC

  • Intellectual Disabilities Intermediate Care Facility
  • Muncie, IN
National Provider Identifier
1003764168
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
DUNGARVIN INDIANA, LLC
Practice address
201 N Manngrove LN
Muncie, IN 47303-4361
Phone
(651) 699-0206
NPI assigned
Mar 16, 2026
Last updated
Mar 16, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
DUNGARVIN GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lori Kress
Title
Ceo
Phone
(651) 789-5906

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

201 N Manngrove LN
Muncie, IN 47303-4361

Mailing address

1444 Northland Dr Ste 200
Mendota Heights, MN 55120-1032

Other names 1

  • Mangrove Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003764168. Details of each certification follow.

  • CCN 15G337 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 15G337

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Dungarvin Indiana LLC
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
May 15, 1987
Last certification
Jan 12, 2026
Beds
8
Ownership / control type
Private (proprietary)
Facility address
201 N Manngrove Dr
Muncie, IN 47303

National Provider Directory

National Provider Directory
Tax ID family
Dungarvin Indiana LLC63 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1773619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773619200000",
    "number": "1003764168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 NORTHLAND DR STE 200",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N MANNGROVE LN",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473034361",
            "telephone_number": "651-699-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUNGARVIN INDIANA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DUNGARVIN GROUP, INC.",
        "enumeration_date": "2026-03-16",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A",
        "authorized_official_last_name": "KRESS",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-789-5906"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mangrove",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.