DUNGARVIN INDIANA, LLC
NPI 1275743205
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in South Bend, IN

Q: What is Dungarvin Indiana, LLC's NPI number?

The NPI number for Dungarvin Indiana, LLC is 1275743205. It was assigned to this organization in the NPPES registry on May 22, 2007.

Q: What is Dungarvin Indiana, LLC's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

Active since May 22, 2007CLIA 15D2036019 · Waiver

3575 MOREAU CT STE 200, SOUTH BEND, IN 46628(574) 245-5400(574) 245-5440 Get Directions Write a Review

NPPES record last updated: April 27, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dungarvin Indiana, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DUNGARVIN INDIANA, LLC (NPI 1275743205) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in South Bend, Indiana and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through January 29, 2028 and lists Lori Kress, Ceo, as its authorized official.

NPPES Registry Identity

NPI1275743205

Entity TypeOrganization

Primary Taxonomy320600000X

Legal Business NameDUNGARVIN INDIANA, LLC

Location Address3575 MOREAU CT STE 200South Bend, IN 46628-4387

Mailing Address1444 Northland Dr Ste 200Mendota Heights, MN 55120-1032 · (651) 699-0206 · Fax (651) 699-0799

Phone(574) 245-5400

Fax(574) 245-5440

Organization SubpartYesParent: Dungarvin Group, Inc.

Authorized OfficialLori KressCeo · (651) 699-0206

Enumeration DateMay 22, 2007

Last NPPES UpdateApril 27, 2023

NPPES CertifiedApril 27, 2023

✔ NPI 1275743205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities

Taxonomy Code320600000X

Definition

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

Also ListedIntermediate Care Facility, Intellectual DisabilitiesTaxonomy 315P00000X

Also ListedCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesTaxonomy 320900000X

3575 MOREAU CT STE 200, South Bend, IN 46628

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Other Identifiers 9

Medicaid100239960IN

Medicaid100245120IN

Medicaid100245230IN

Medicaid100244770IN

Medicaid100244780IN

Medicaid100239800IN

Medicaid100244830IN

Medicaid100244950IN

Medicaid100230070IN

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D2036019

Dungarvin Indiana LLC · South Bend, IN

Active · expires Jan 29, 2028

CLIA Number15D2036019

Laboratory TypeAssisted Living Facility

Certificate Effective DateJanuary 30, 2026

Certificate Expiration DateJanuary 29, 2028

Laboratory DirectorRick Adams

Laboratory Phone(574) 245-5400

Laboratory LocationDungarvin Indiana LLC3521 Oxford Lane, South Bend, IN 46615

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TRACIE M NAILLIEUX

Registered Nurse

3575 MOREAU CT STE 200
SOUTH BEND, IN 46628

St. Joseph County (219) 248-3666

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dungarvin Indiana, LLC's NPI number?

The NPI number for Dungarvin Indiana, LLC is 1275743205. It was assigned to this organization in the NPPES registry on May 22, 2007.

Where is Dungarvin Indiana, LLC located?

Dungarvin Indiana, LLC is located at 3575 Moreau Ct Ste 200, South Bend, IN 46628. The listed phone number is (574) 245-5400.

What is Dungarvin Indiana, LLC's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

Does Dungarvin Indiana, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2036019) is associated with this NPI, valid through January 29, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dungarvin Indiana, LLC was last updated on April 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.