Corvilla Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

CORVILLA INC.

Practice address

18443 Bulla Rd
South Bend, IN 46637-5426

Phone

(574) 277-8129

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Julie A Lucky, MPA

Title

Executive Director

Phone

(574) 289-9779

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 15G214

Legal name

CORVILLA INC

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Nov 6, 1985

Last certification

Sep 19, 2025

Beds

8

Ownership / control type

Private (non-profit)

Facility address

18443 Bulla Rd
South Bend, IN 46637

Locations

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265553606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 SUGAR MAPLE BUSINESS CT",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466284372",
            "telephone_number": "574-289-9779",
            "fax_number": "574-289-0185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18443 BULLA RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466375426",
            "telephone_number": "574-277-8129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORVILLA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUCKY",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "574-289-9779",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MPA"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Filia Corning, PHD
• Alejandro Corona Espinosa, PH.D., HSPP
• Aileen Corona
• August Noelani Corso, RD
• Sean Corthier
• David A Cory, M.D.
• Olga Costilla
• Aryana Nitchelle Coughlin
• Christine Elizabeth Coulter, MSN, FNP
• Alma Delia Counsellor

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in South Bend, IN
• Providers in South Bend, IN by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.