South Bend Behavioral Health LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

SOUTH BEND BEHAVIORAL HEALTH LLC

Practice address

701 N Niles Ave
South Bend, IN 46617-1923

Phone

(843) 609-5885

NPI assigned

Dec 5, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Joshua Smith, MBA

Title

Ceo

Phone

(843) 609-5885

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543968000000",
    "number": "1659842490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171923",
            "telephone_number": "843-609-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171923",
            "telephone_number": "843-609-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BEND BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-05",
        "last_updated": "2018-12-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-609-5885",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental Disabilities Clinic/Center in South Bend, IN
• Providers in South Bend, IN by specialty
• Developmental Disabilities Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.