Individual provider · Type 1 NPI

Stacey Phipps

Nursing Facility/Intermediate Care Facility · South Bend, IN

NPI number 1265716146 Active

Practice location

1950 Ridgedale Rd
South Bend, IN 46614-2243

Call (574) 291-6722 Map

Mailing address

2612 Southridge Dr
South Bend, IN 46614-1536

Specialties and licenses

TaxonomyCodeLicense
Nursing Facility/Intermediate Care Facility Primary 313M00000X32001430A (IN)

Nursing Facility/Intermediate Care Facility: An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical conditi…

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About NPI 1265716146

Stacey Phipps's National Provider Identifier is 1265716146, issued on Oct 10, 2011. The primary taxonomy on file is Nursing Facility/Intermediate Care Facility (313M00000X), and the practice location is in South Bend, IN. The record was last updated on Oct 10, 2011.