NPIMap

Organization Active NPI

Northern Indiana Interim Healthcare Company LLC

  • Home Health Agency
  • Mishawaka, IN
National Provider Identifier
1710974068
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
04006118 Issued in IN
Legal business name
NORTHERN INDIANA INTERIM HEALTHCARE COMPANY LLC
Practice address
605 W Edison Rd
Suite H
Mishawaka, IN 46545-8823
Phone
(574) 252-5186
Fax
(574) 233-5245
NPI assigned
Oct 3, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Authorized official

Name
Steven James Alessandro
Title
Ce0
Phone
(847) 457-1808

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 04006118 IN Primary

Addresses

Primary practice location

605 W Edison Rd
Suite H
Mishawaka, IN 46545-8823

Mailing address

605 W Edison Rd Ste H
Mishawaka, IN 46545-8823
Phone (574) 252-5186

Other identifiers 2

IdentifierTypeStateIssuer
200398720AMedicaidIN
200 401 030AMedicaidIN

Other names 1

  • Interim Healthcare of South Bend, IN Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040930000333 IN Part A Provider - Home Health Agency 7315916921 Practice locations: Merrillville, IN; Mishawaka, IN

Home health agency certification: CCN 157048

Legal name
NORTHERN INDIANA INTERIM HEALTHCARE COMPANY LLC
Doing business as
INTERIM HEALTHCARE OF SOUTH BEND
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 11, 1977
Last certification
Sep 16, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
605 W. Edison Road
Suite H
Mishawaka, IN 45645

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Interim Healthcare of South BendCCN 157048
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Jul 11, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D0883018Interim Healthcare of South Bend605 W Edison Rd, Mishawaka, IN 46545Certificate of waiverFeb 21, 2028

National Provider Directory

National Provider Directory
Tax ID family
Northern Indiana Interim4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
James R Wesner Individual 5% Or Greater Direct Ownership InterestOwner Aug 29, 2019 45%
Operational/Managerial ControlOwner Aug 28, 2019 45%
Preston Lucas Individual 5% Or Greater Direct Ownership InterestCfo Jul 1, 2025 10%
Corporate OfficerCfo Jun 2, 2025 100%
Steven J Alessandro Individual 5% Or Greater Direct Ownership InterestChief Executive Officer Aug 29, 2019 45%
Corporate OfficerChief Executive Officer Aug 29, 2019 45%
Operational/Managerial ControlChief Executive Officer Aug 29, 2019 45%
Northern Indiana Interim Healthcare Company LLC Organization, Mishawaka, IN 5% Or Greater Direct Ownership Interest Jun 14, 2010

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Interim Health Care of Fort WayneFort Wayne, IN, CCN 157627 Home health agency 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jun 14, 2010
Jun 14, 2010
Interim Healthcare of Fort WayneFort Wayne, IN, CCN 151657 Hospice 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 8, 2002
Jul 8, 2002

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757376000000",
    "number": "1710974068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 W EDISON RD STE H",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465458823",
            "telephone_number": "574-252-5186",
            "fax_number": "574-233-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 W EDISON RD",
            "address_2": "SUITE H",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465458823",
            "telephone_number": "574-252-5186",
            "fax_number": "574-233-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN INDIANA INTERIM HEALTHCARE COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A",
        "authorized_official_last_name": "ALESSANDRO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CE0",
        "authorized_official_telephone_number": "847-457-1808"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IN",
            "license": "04006118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200398720A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200 401 030A",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd SteB",
            "city": "BROWNSVILLE",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Interim Healthcare of South Bend, IN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.