NPIMap

Organization Active NPI

Logan Community Resources, Inc.

  • Behavior Analyst
  • Benton Harbor, MI
National Provider Identifier
1861071789
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
LOGAN COMMUNITY RESOURCES, INC.
Doing business as
Logan Autism Learning Center
Practice address
1651 E Nickerson Ave
Benton Harbor, MI 49022-2469
Phone
(269) 983-5833
Fax
(269) 363-4630
NPI assigned
Apr 7, 2021
Organization subpart
Yes
Parent organization
LOGAN COMMUNITY RESOURCES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Authorized official

Name
Maria Fernandez
Title
Manager of Revenue Cycle
Phone
(626) 531-2992

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

1651 E Nickerson Ave
Benton Harbor, MI 49022-2469

Mailing address

1651 E Nickerson Ave
Benton Harbor, MI 49022-2469
Phone (269) 983-5833

Other names 1

  • Logan Autism Learning Center Doing business as

National Provider Directory

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

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": "1617753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618272000000",
    "number": "1861071789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 E NICKERSON AVE",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490222469",
            "telephone_number": "269-983-5833",
            "fax_number": "269-363-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 E NICKERSON AVE",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490222469",
            "telephone_number": "269-983-5833",
            "fax_number": "269-363-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN COMMUNITY RESOURCES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOGAN COMMUNITY RESOURCES, INC.",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "MANAGER OF REVENUE CYCLE",
        "authorized_official_telephone_number": "626-531-2992"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Logan Autism Learning Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Benton Harbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.