LOGAN COMMUNITY RESOURCES INC NPI 1003026642

NPI Information

LOGAN COMMUNITY RESOURCES, INC is a residential treatment facility, intellectual and/or developmental disabilities in South Bend, IN. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. LOGAN COMMUNITY RESOURCES, INC NPI is 1003026642. The provider is registered as an organization entity type.

The provider's business location address is:

2105 WABASH ST
SOUTH BEND, IN
ZIP 46613-138
Phone: (574) 289-4831
Fax: (574) 234-2075

The provider's authorized official is Dan Harshman .
The authorized official title is Ceo and has the following contact phone number (574) 289-4831.

The CLIA number assigned to this NPI record is 15D0919942 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/23/2007 and was last updated on 8/22/2020.

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:

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