DIXON MWOSE NPI 1598474652

NPI Information

NPI: 1598474652
Provider Name: DIXON MWOSE
Classification: Day Training/Habilitation Specialist - 373H00000X
Entity Type: Individual
Address:
2610 E JEFFERSON BLVD
SOUTH BEND, IN
ZIP 46615
Phone: (574) 276-5026
Get Directions

Dixon Mwose is a day training habilitation specialist in South Bend, IN. The provider is individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills that enable them to cope more effectively with the demands of independent living. Dixon Mwose NPI is 1598474652. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2610 E JEFFERSON BLVD
SOUTH BEND, IN
ZIP 46615-724
Phone: (574) 276-5026
Fax: (574) 251-0869

The enumeration date for this NPI number is 11/17/2022 and was last updated on 11/30/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	171W00000X	Contractor		201371060-A	INDIANA	No
2	373H00000X	Day Training/Habilitation Specialist		201371060-A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	47-3518606	MEDICAID	INDIANA
2	201371060A	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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