NPIMap

Organization Active NPI

Logan Community Resources

  • Developmentally Disabled Services Day Training Agency
  • South Bend, IN
National Provider Identifier
1033378807
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
LOGAN COMMUNITY RESOURCES
Practice address
2505 E Jefferson Blvd
South Bend, IN 46615-2635
Phone
(574) 289-4831
NPI assigned
Jun 5, 2008
Last updated
Jun 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Dan Harshman
Title
Ceo
Phone
(574) 289-4831

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X NU Primary

Addresses

Primary practice location

2505 E Jefferson Blvd
South Bend, IN 46615-2635

Mailing address

PO Box 1049
South Bend, IN 46624-1049
Phone (574) 289-4831

Other identifiers 1

IdentifierTypeStateIssuer
200713940MedicaidIN

Other names 1

  • Logan Building Blocks Other name

National Provider Directory

National Provider Directory
Tax ID family
Logan Community Resources Inc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

2505 E Jefferson Blvd
South Bend, IN 46615
Phone (574) 282-2848

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1033378807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1049",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466241049",
            "telephone_number": "574-289-4831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 E JEFFERSON BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466152635",
            "telephone_number": "574-289-4831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN COMMUNITY RESOURCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "HARSHMAN",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "574-289-4831",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200713940",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Logan Building Blocks",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.