MEDICARE: THE CHILDREN'S CAMPUS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320800000X	Mental Illness Community Based Residential Treatment Facility	43486	IN

General Provider Information

NPI Number	:	1841460813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CHILDREN'S CAMPUS, INC.

Provider Business Mailing Address
First Line	:	1411 LINCOLNWAY W
Second Line	:
City	:	MISHAWAKA
State	:	IN
Zip	:	46544-1626
Country	:	US
Telephone Number	:	574-259-5666
Fax Number	:

Provider Business Practice Location Address
First Line	:	1028 E WAYNE ST
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46617-3026
Country	:	US
Telephone Number	:	574-289-7956
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	KRISTIN ERMETI
Credential	:
Telephone Number	:	574-259-5666

Provider Enumeration Date	:	03/06/2008
Last Update Date	:	03/06/2008

Similar Medicare Providers

1245315811 — DR. LUIS A. RAMIREZ M.D.
Practice Location Address:

8021 BIG BEND DR
EL PASO, TX
79904-3026

Practice Phone: 915-630-2072
Practice Fax: 915-440-8385

1134697766 — MEGAN KATHLEEN REEL LMFT
Practice Location Address:

1049 ORANGE GROVE AVE
SOUTH PASADENA, CA
91030-3026

Practice Phone: 931-303-6813
Practice Fax:

1386699338 — MS. STEPHANIE J FERRERA LCSW
Practice Location Address:

200 SOUTH MAPLE AVENUE
OAK PARK, IL
60302-3026

Practice Phone: 708-383-7566
Practice Fax: 708-383-4766

1780839746 — UNIVERSITY OF CHICAGO
Practice Location Address:

5841 SOUTH MARYLAND , MC 3026
CHICAGO, IL
60637

Practice Phone: 773-702-2123
Practice Fax:

1710252945 — LACHELLE L BARNETT MSW
Practice Location Address:

415 E MADISON ST
SOUTH BEND, IN
46617-2322

Practice Phone: 574-283-1234
Practice Fax: 574-283-1361

1528636925 — DANIELLE BAE
Practice Location Address:

211 N EDDY ST
SOUTH BEND, IN
46617-3096

Practice Phone: 574-246-8816
Practice Fax:

Directions to “THE CHILDREN'S CAMPUS, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.