# COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY
- **Other names:** Indian Lake Community Health Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1295294890
- **Legal business name:** COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY
- **Authorized official:** KASSANDRA ROBB (RCM)
- **Authorized official phone:** (937) 599-1413

## Contact information

- **Practice address:** 8200 STATE ROUTE 366 STE 1, RUSSELLS POINT, OH 43348-9670
- **Practice address phone:** (937) 599-1411
- **Practice address fax:** (937) 599-4128
- **Mailing address:** 4879 US HIGHWAY 68 S, WEST LIBERTY, OH 43357-9525
- **Mailing address phone:** (937) 599-1411
- **Mailing address fax:** (937) 599-4128

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QF0400X | Federally Qualified Health Center (FQHC) | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/14/2019
- **Last updated:** 08/14/2026