Provider Demographics
NPI:1639662596
Name:MISHAWAKA RCF LP
Entity Type:Organization
Organization Name:MISHAWAKA RCF LP
Other - Org Name:SILVER BIRCH OF MISHAWAKA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAILA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-933-1523
Mailing Address - Street 1:121 W WACKER DR STE 400
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-1781
Mailing Address - Country:US
Mailing Address - Phone:312-933-1523
Mailing Address - Fax:312-488-1919
Practice Address - Street 1:3630 HICKORY RD
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545
Practice Address - Country:US
Practice Address - Phone:574-252-7225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-14
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility