NPIMap

Organization Active NPI

Logan Community Resources, Inc

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • South Bend, IN
National Provider Identifier
1164632105
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
LOGAN COMMUNITY RESOURCES, INC
Practice address
1602 Orkney Dr
South Bend, IN 46614-3562
Phone
(574) 289-4831
Fax
(574) 234-2075
NPI assigned
May 22, 2007
Last updated
Dec 14, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

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
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X NU Primary

Addresses

Primary practice location

1602 Orkney Dr
South Bend, IN 46614-3562

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164632105. Details of each certification follow.

  • CCN 15G222 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 15G222

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
LOGAN COMMUNITY RESOURCES INC
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Dec 29, 1985
Last certification
May 13, 2025
Beds
7
Ownership / control type
Private (non-profit)
Most recent change of ownership
Dec 18, 2018
Facility address
1602 Orkney Drive
South Bend, IN 46614

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

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197590400000",
    "number": "1164632105",
    "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",
            "fax_number": "574-234-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 ORKNEY DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466143562",
            "telephone_number": "574-289-4831",
            "fax_number": "574-234-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN COMMUNITY RESOURCES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-12-14",
        "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": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.