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LOGAN COMMUNITY RESOURCES, INC.
NPI 1891917449
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in South Bend, IN

Active since May 03, 2007
2505 E. JEFFERSON BLVD, SOUTH BEND, IN 46615(574) 289-4831(574) 234-2075 Get Directions Write a Review

NPPES record last updated: August 1, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Logan Community Resources, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LOGAN COMMUNITY RESOURCES, INC. (NPI 1891917449) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in South Bend, Indiana and active in the NPI registry since May 2007. The organization lists Clint Bolser, Ceo, as its authorized official.

NPPES Registry Identity

NPI1891917449
Entity TypeOrganization
Primary Taxonomy320600000X
Legal Business NameLOGAN COMMUNITY RESOURCES, INC.
Location Address2505 E. JEFFERSON BLVDSouth Bend, IN 46615
Mailing Address2505 E. Jefferson BlvdSouth Bend, IN 46615 · (574) 289-4831 · Fax (574) 234-2075
Phone(574) 289-4831
Fax(574) 234-2075
Organization SubpartNo
Authorized OfficialClint BolserCeo · (574) 289-4831
Enumeration DateMay 3, 2007
Last NPPES UpdateAugust 1, 2012
✔ NPI 1891917449 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320600000X
Definition
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.
Also ListedDay Training, Developmentally Disabled ServicesTaxonomy 251C00000X
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesTaxonomy 320900000X
2505 E. JEFFERSON BLVD, South Bend, IN 46615
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Other Identifiers 2

Medicaid100108330IN
Medicaid201036530IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Logan Community Resources, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Logan Community Resources, Inc., which bills Medicare for the services this clinician delivers.

Clinician (1)

Allison Haynes, LLMSW
Clinical Social Worker
NPI 1649622747
1651 E NICKERSON AVE
Benton Harbor, MI 49022
(269) 983-5833
✔ PECOS29 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Logan Community Resources, Inc.'s NPI number?

The NPI number for Logan Community Resources, Inc. is 1891917449. It was assigned to this organization in the NPPES registry on May 3, 2007.

Where is Logan Community Resources, Inc. located?

Logan Community Resources, Inc. is located at 2505 E. Jefferson Blvd, South Bend, IN 46615. The listed phone number is (574) 289-4831.

What is Logan Community Resources, Inc.'s specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

Is Logan Community Resources, Inc. enrolled in Medicare?

Yes. Logan Community Resources, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Logan Community Resources, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Logan Community Resources, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Logan Community Resources, Inc. accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Blue Care Network of Michigan and 5 other insurers list Logan Community Resources, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Logan Community Resources, Inc. was last updated on August 1, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.