The Randolph Logan Group LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

THE RANDOLPH LOGAN GROUP LLC

Practice address

2403 W Walnut St
Colmar, PA 18915-9704

Phone

(484) 213-0043

NPI assigned

Dec 20, 2023

Last updated

Dec 20, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Danae Logan, MS

Title

Ceo

Phone

(610) 850-5001

Specialties & licenses 2

Addresses

Tax ID family

The Randolph Logan Group LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• The Randolph Logan Group LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Colmar, PA
  • NPI 1457246860
  NPD tax ID

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1639948508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W GERMANTOWN PIKE STE 400",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621046",
            "telephone_number": "610-850-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 W WALNUT ST",
            "city": "COLMAR",
            "state": "PA",
            "postal_code": "189159704",
            "telephone_number": "484-213-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RANDOLPH LOGAN GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-20",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "DANAE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "610-850-5001",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sukhdev Singh, D.M.D.
• Cara Ann Slugaski, DMD
• Lisa A Stahlecker, DDS
• Avril Hope Takiff, LCSW
• The Randolph Logan Group LLC
• Thomas C Detweiler,MD
• Julia Thompson, LMFT
• Tranquil & Serene Integrative Care, LLC
• Trunks of Love Home Care LLC
• James E Veverka, LCSW

• Mental Illness Community Based Residential Treatment Facility in Colmar, PA
• Providers in Colmar, PA by specialty
• Mental Illness Community Based Residential Treatment Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.