Mishawaka Il/Al, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MISHAWAKA IL/AL, LLC

Practice address

1025 Park PL
Mishawaka, IN 46545-3528

Phone

(574) 247-1552

NPI assigned

Oct 1, 2024

Organization subpart

No

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

Authorized official

Name

Jonathan Litt

Title

Secretary / Treasurer

Phone

(646) 844-3603

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1154149896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 PARK PL",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453528",
            "telephone_number": "574-247-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 PARK PL",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465453528",
            "telephone_number": "574-247-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISHAWAKA IL/AL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "LITT",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "SECRETARY / TREASURER",
        "authorized_official_telephone_number": "646-844-3603"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Assisted Living Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.