ICR ADOLESCENTS OPERATING SUBSIDIARY, LLC – NPI #1932058369
Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
ICR ADOLESCENTS OPERATING SUBSIDIARY, LLC is an AHC clinic located in MISHAWAKA, IN. NPPES has assigned the NPI number 1932058369 to ICR ADOLESCENTS OPERATING SUBSIDIARY, LLC on January 27, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QM0855X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Adolescent and Children Mental Health
The NPI profile was last updated on May 28, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ICR ADOLESCENTS OPERATING SUBSIDIARY, LLC below.
NPI Profile for
ICR ADOLESCENTS OPERATING SUBSIDIARY, LLC
(about 4 months ago)
MISHAWAKA, IN 46544-1917 Phone: (574) 544-0207 Fax:
PALM SPRINGS, FL 33461-3000 Phone: Fax:
AUTHORIZED OFFICIAL
Phone: (561) 517-3400
Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 261QM0855X - Clinic/Center / Adolescent and Children Mental Health (Primary) |
||
| 3245S0500X - Substance Abuse Rehabilitation Facility / Substance Abuse Treatment, Children |
||
| 261QR0405X - Clinic/Center / Rehabilitation, Substance Use Disorder |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.