Logan Community Resources, Inc

NPI 1003026642 - Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities - 320600000X

NPI Details
NPI 1003026642
Enumeration Date 05/23/2007
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name DAN DAN
Position CEO
Phone (574) 289-4831
Fax (574) 234-2075
Practice Location
2105 WABASH ST
SOUTH BEND IN, 46613-1138, US
Phone (574) 289-4831
Fax (574) 234-2075
Business Location
PO BOX 1049
SOUTH BEND IN, 46624-1049, US
Phone (574) 289-4831
Fax (574) 234-2075
Toxanomy
Taxonomy Code 320600000X
License State
License Number
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According to our database, Logan Community Resources, Inc NPI is 1003026642, taxonomy code is 320600000X Logan Community Resources, Inc physically located at 2105 Wabash St, South Bend IN, 46613-1138. NPI Number 1033115704 has the healthcare provider type.

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1003026642 NPI number is provided on an as is basis without warranty of any kind. 1003026642 is maintained by the National Plan & Provider Enumeration System. The contents of Logan Community Resources, Inc are for informational purposes only.