Whalio Doctors

NPI 1003026642

Logan Community Resources, INC

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility South Bend, IN

Practice location

Address
2105 Wabash St, South Bend, IN 46613-1138
Phone
(574) 289-4831
Fax
(574) 234-2075
Mailing address
PO Box 1049, South Bend, IN 46624-1049

Authorised official

Name
Dan Harshman
Title
Ceo
Phone
(574) 289-4831

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320600000X

Registry record

NPI
1003026642
Entity type
Organization
NPI issued
23 May 2007
Record last updated
22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.