NPI 1164632105

Logan Community Resources, INC

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

Practice location

Address: 1602 Orkney Dr, South Bend, IN 46614-3562
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

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Registry record

NPI: 1164632105
Entity type: Organization
NPI issued: 22 May 2007
Record last updated: 14 Dec 2007

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.