Healthcare Provider Details

I. General information

NPI: 1144178237
Provider Name (Legal Business Name): DUNGARVIN INDIANA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4949 HAYES ST
GARY IN
46408-4353
US

IV. Provider business mailing address

1444 NORTHLAND DR STE 200
MENDOTA HEIGHTS MN
55120-1032
US

V. Phone/Fax

Practice location:
  • Phone: 651-699-0206
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: LORI KRESS
Title or Position: CEO
Credential:
Phone: 651-789-5906