MEDICARE: LUMINARY HOSPICE OF SOUTH BEND, LLC

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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1053204677
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUMINARY HOSPICE OF SOUTH BEND, LLC

Provider Business Mailing Address
First Line	:	7321 HERITAGE SQUARE DR STE 2120
Second Line	:
City	:	GRANGER
State	:	IN
Zip	:	46530-5660
Country	:	US
Telephone Number	:	317-814-6190
Fax Number	:

Provider Business Practice Location Address
First Line	:	7321 HERITAGE SQUARE DR STE 2120
Second Line	:
City	:	GRANGER
State	:	IN
Zip	:	46530-5660
Country	:	US
Telephone Number	:	317-814-6190
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SETH RAINFORD
Credential	:
Telephone Number	:	630-864-8820

Provider Enumeration Date	:	06/02/2025
Last Update Date	:	03/03/2026

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