Logan Community Resources, Inc.

LBN: Logan Community Resources, Inc.
Logan Community Resources, Inc. is an health care organization with primary practice located at 2505 E. Jefferson Blvd , South Bend IN 46615. The organization recently has 4 registered licenses in different health care specialties including Agencies / Day Training, Developmentally Disabled Services, Agencies / Community/Behavioral Health, Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities is the primary health care specialty. Logan Community Resources, Inc. can be contacted via phone (574) 289-4831, or through Bolser, Clint via phone (574) 289-4831.

Contact Information

Primary practice address
2505 E. Jefferson Blvd South Bend IN 46615
Phone: (574) 289-4831
Fax: (574) 234-2075
Website:
Map and Directions
Authorized official contact:
Name: Bolser, Clint
Phone: (574) 289-4831

Health care specialties

SpecialtyCodeLicense #State
Agencies / Day Training, Developmentally Disabled Services 251C00000X
Agencies / Community/Behavioral Health 251S00000X
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X

Profile Details

NPI number 1891917449
LBN Legal business name Logan Community Resources, Inc.
DBA Doing business as
Authorized official Bolser, Clint
Entity Organization
Organization subpart 1 No
Enumeration date May 3rd, 2007
Last updated Aug 1st, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891917449 NPPES
Indiana MEDICAID 100108330
Indiana MEDICAID 201036530

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