NPI 1093083461

Logan Community Resources, INC

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

Practice location

Address: 2505 E Jefferson Blvd, South Bend, IN 46615-2635
Phone: (574) 289-4831
Fax: (574) 234-2075

Authorised official

Name: Sharron Carter
Title: Cfo
Phone: (574) 289-4831

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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Registry record

NPI: 1093083461
Entity type: Organization
NPI issued: 13 Dec 2011
Record last updated: 13 Dec 2011

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.