Gumbo LLC

Skilled Nursing Facility · Mishawaka, IN

Organization Active NPI

NPI number 1982000964

Practice location

2618 River Ave
Mishawaka, IN 46544-1568
Phone
(269) 240-7881

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NPI record

NPI
1982000964
Entity type
Organization (Type 2)
Enumeration date
November 18, 2014
Last updated
November 18, 2014
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Skilled Nursing Facility Primary 314000000X 28188157A IN

Authorized official

Name
Michael Gumbo, R.N.,BSN
Title
CEO
Phone
(269) 240-7881

About Gumbo LLC

Gumbo LLC is a healthcare organization registered in the NPI registry with the primary taxonomy Skilled Nursing Facility (code 314000000X). The practice location is 2618 River Ave, Mishawaka, IN 46544-1568. The NPI number 1982000964 was assigned on November 18, 2014 and the record was last updated on November 18, 2014.

Gumbo LLC lists a license in the registry: #28188157A (IN) for Skilled Nursing Facility. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Michael Gumbo, R.N.,BSN, CEO.

Frequently asked questions

What is the NPI number of Gumbo LLC?

The NPI number is 1982000964.

What is the phone number of Gumbo LLC?

The phone number listed for the practice location is (269) 240-7881.

Where is Gumbo LLC located?

2618 River Ave, Mishawaka, IN 46544-1568.

What is the taxonomy code for Gumbo LLC?

The primary taxonomy code is 314000000X – Skilled Nursing Facility.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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