1. Home
  2. Directory
  3. Indiana
  4. Mishawaka
  5. Substance Abuse Rehabilitation Facility
  6. NPI Profile

INDIANA CENTER FOR RECOVERY ADOLESCENT PROGRAM LLC
NPI 1457196735
Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children in Mishawaka, IN

Active since June 27, 2024
215 W 4TH ST, MISHAWAKA, IN 46544(561) 305-0461 Get Directions Write a Review

NPPES record last updated: January 14, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 14, 2026, Jul 5, 2024, Jun 27, 2024 (3 updates tracked since 2024).

About Indiana Center For Recovery Adolescent Program Llc NPPES

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

INDIANA CENTER FOR RECOVERY ADOLESCENT PROGRAM LLC (NPI 1457196735) is a healthcare organization registered as a substance abuse treatment, children in Mishawaka, Indiana and active in the NPI registry since June 2024. The organization lists Kirill Vesselov, President, as its authorized official.

NPPES Registry Identity

NPI1457196735
Entity TypeOrganization
Primary Taxonomy3245S0500X
Legal Business NameINDIANA CENTER FOR RECOVERY ADOLESCENT PROGRAM LLC
Location Address215 W 4TH STMishawaka, IN 46544-1917
Mailing Address2925 10th Ave NPalm Springs, FL 33461-3000
Phone(561) 305-0461
Organization SubpartNo
Authorized OfficialKirill VesselovPresident · (561) 396-5849
Enumeration DateJune 27, 2024
Last NPPES UpdateJanuary 14, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 14, 2026
✔ NPI 1457196735 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtySubstance Abuse Rehabilitation Facility · Substance Abuse Treatment, ChildrenResidential Treatment Facilities
Taxonomy Code3245S0500X
Definition
A facility or distinct part of a facility for children that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.
Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X
Also ListedPsychiatric Residential Treatment FacilityTaxonomy 323P00000X
215 W 4TH ST, Mishawaka, IN 46544
Open in Google Maps ↗

Other Providers at the Same Location NPPES 19

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

RIVER BEND ANESTHESIA, LLC
Anesthesiology
215 W 4TH ST
MISHAWAKA, IN 46544
St. Joseph County (574) 271-0013
ICR SOUTH BEND OPERATING SUBSIDIARY, LLC
Psychiatric Hospital
215 W 4TH ST
MISHAWAKA, IN 46544
St. Joseph County (574) 544-0207
SCCI HOSPITALS OF AMERICA, LLC
Long Term Care Hospital
215 W 4TH ST
MISHAWAKA, IN 46544
St. Joseph County (574) 251-8238
SELECT SPECIALTY HOSPITAL - NORTHERN INDIANA, LLC
Long Term Care Hospital
215 W 4TH ST, 2ND FLOOR
MISHAWAKA, IN 46544
St. Joseph County (717) 972-1100
INDIANA CENTER FOR RECOVERY SOUTH BEND, LLC
Psychiatric Hospital
215 W 4TH ST
MISHAWAKA, IN 46544
St. Joseph County (561) 305-0461
SELECT SPECIALTY HOSPITAL - NORTHERN INDIANA, LLC
Hospitalist
215 W 4TH ST, 2ND FL
MISHAWAKA, IN 46544
St. Joseph County (717) 972-1100
SOUND PHYSICIANS OF INDIANA, LLC
Hospitalist
215 W 4TH ST, # 200
MISHAWAKA, IN 46544
St. Joseph County (574) 252-2000
LESLY STEWART PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
215 W 4TH ST
MISHAWAKA, IN 46544
St. Joseph County (574) 544-0101

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 Indiana Center For Recovery Adolescent Program LLC's NPI number?

The NPI number for Indiana Center For Recovery Adolescent Program LLC is 1457196735. It was assigned to this organization in the NPPES registry on June 27, 2024.

Where is Indiana Center For Recovery Adolescent Program LLC located?

Indiana Center For Recovery Adolescent Program LLC is located at 215 W 4th St, Mishawaka, IN 46544. The listed phone number is (561) 305-0461.

What is Indiana Center For Recovery Adolescent Program LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility, specializing in Substance Abuse Treatment, Children, with taxonomy code 3245S0500X.

When was this NPI record last updated?

The NPPES record for Indiana Center For Recovery Adolescent Program LLC was last updated on January 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.