South Bend Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SOUTH BEND ASSISTED LIVING LLC

Doing business as

DBA Wood Ridge Assisted Living Community

Practice address

17650 Generations Dr
South Bend, IN 46635-1536

Phone

(574) 271-1151

Fax

(571) 271-2812

NPI assigned

Apr 23, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Judith Elaine Hoese, HFA

Title

Administrator

Phone

(574) 271-1151

Specialties & licenses 1

Addresses

Other names 1

• DBA Wood Ridge Assisted Living Community Doing business as

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": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801014147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17650 GENERATIONS DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351536",
            "telephone_number": "574-271-1151",
            "fax_number": "571-271-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17650 GENERATIONS DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351536",
            "telephone_number": "574-271-1151",
            "fax_number": "571-271-2812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BEND ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOESE",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "574-271-1151",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "HFA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Wood Ridge Assisted Living Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in South Bend, IN
• Providers in South Bend, 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 Aug 22, 2020; 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.