NPIMap

Organization Active NPI

Dungarvin Indiana, LLC

  • Intellectual Disabilities Intermediate Care Facility
  • Logansport, IN
National Provider Identifier
1720935836
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
102 Oaktree CT
Logansport, IN 46947-4115
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

102 Oaktree CT
Logansport, IN 46947-4115

Mailing address

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

Other names 1

  • Oak Tree 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 1720935836. Details of each certification follow.

  • CCN 15G498 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 15G498

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
Aug 22, 1989
Last certification
Feb 17, 2026
Beds
6
Ownership / control type
Private (proprietary)
Most recent change of ownership
Jun 19, 2020
Facility address
102 Oaktree CT
Logansport, IN 46947

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 24

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

View all 24

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": "1720935836",
    "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": "102 OAKTREE CT",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469474115",
            "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": "Oak Tree",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Logansport, IN

Sources for this page

Verify at the official NPI Registry.