ICR ADOLESCENTS OPERATING SUBSIDIARY, LLC
NPI 1932058369
Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children in Mishawaka, IN
- Organization
- Substance Abuse Rehabilitation Facility
- Substance Abuse Treatment, Children
- CLIA Number: 15D2313729
- CLIA Cert. Type: Other - SUBSTANCE ABUSE FACILITY
- CLIA Exp. Date: 11-05-2026
About ICR ADOLESCENTS OPERATING SUBSIDIARY, LLC
This page provides the complete NPI Profile along with additional information for Icr Adolescents Operating Subsidiary, Llc, a provider established in Mishawaka, Indiana operating as a Substance Abuse Rehabilitation Facility, focusing in substance abuse treatment, children . The healthcare provider is registered in the NPI registry with number 1932058369 assigned on January 2026. The practitioner's primary taxonomy code is 3245S0500X. The provider is registered as an organization and their NPI record was last updated July 2026. The authorized official of this NPI record is Tara Gurney (Authorized Official)
- NPI
- 1932058369
- Provider Name
- ICR ADOLESCENTS OPERATING SUBSIDIARY, LLC
- Entity Type
- Organization
- Location Address
- 215 W 4TH ST MISHAWAKA, IN 46544
- Location Phone
- (574) 544-0207
- Mailing Address
- 2925 10TH AVE N PALM SPRINGS, FL 33461
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-27-2026
- Last Update Date
- 07-10-2026
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children
- Taxonomy Code
- 3245S0500X
- Type
- Residential Treatment Facilities
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | |
| 2 | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | |
| 3 | 323P00000X | Residential Treatment Facilities | Psychiatric Residential Treatment Facility |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 15D2313729
- Facility Type
- Other - SUBSTANCE ABUSE FACILITY
- Certificate Effective Date
- November 06, 2024
- Certificate Expiration Date
- November 05, 2026
- Laboratory Director
- MICHAEL KANE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Icr Adolescents Operating Subsidiary, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1932058369, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 19 providers are registered at the same or a nearby location.
MISHAWAKA, IN 46544
MISHAWAKA, IN 46544
MISHAWAKA, IN 46544
MISHAWAKA, IN 46544
MISHAWAKA, IN 46544
MISHAWAKA, IN 46544
MISHAWAKA, IN 46544
MISHAWAKA, IN 46544
MISHAWAKA, IN 46544
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1932058369, enumerated as an "organization" on January 27, 2026.
The provider is located at 215 W 4TH ST MISHAWAKA, IN 46544 and the phone number is (574) 544-0207.
Substance Abuse Rehabilitation Facility with taxonomy code 3245S0500X and a focus in Substance Abuse Treatment, Children.
