NPI 1265553606

Corvilla INC.

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility South Bend, IN

Practice location

Address: 18443 Bulla Rd, South Bend, IN 46637-5426
Phone: (574) 277-8129
Mailing address: 3231 Sugar Maple Business CT, South Bend, IN 46628-4372

Authorised official

Name: Julie a Lucky
Title: Executive Director
Phone: (574) 289-9779

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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Registry record

NPI: 1265553606
Entity type: Organization
NPI issued: 3 Apr 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.