LOGAN COMMUNITY RESOURCES, INC NPI 1003026642

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

NPI 1003026642 Organization Residential Treatment Facility, Intellec...

About LOGAN COMMUNITY RESOURCES, INC

Logan Community Resources, Inc is a provider established in South Bend, Indiana specializing in residential treatment facility, intellectual and/or developmental disabilities. The NPI number of Logan Community Resources, Inc is 1003026642 and was assigned on May 2007. The practitioner's primary taxonomy code is 320600000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Mr. Dan Harshman (Ceo)

NPI

1003026642

Provider NameLOGAN COMMUNITY RESOURCES, INC
Provider Location Address2105 WABASH ST SOUTH BEND, IN 46613
Provider Mailing AddressPO BOX 1049 SOUTH BEND, IN 46624
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date05-23-2007
Last Update Date08-22-2020


Primary Taxonomy

Taxonomy Code320600000X
ClassificationResidential Treatment Facility, Intellectual and/or Developmental Disabilities
TypeResidential Treatment Facilities
Taxonomy DescriptionA 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.

Business Address

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

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Mailing Address

LOGAN COMMUNITY RESOURCES, INC
PO BOX 1049
SOUTH BEND, IN
ZIP 46624
Phone: (574) 289-4831
Fax: (574) 234-2075



Authorized Official

Authorized Official NameMR. DAN HARSHMAN
Authorized Official TitleCEO
Authorized Official Phone(574) 289-4831

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.