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Organization
CITY OF LOGAN
Active
Organization
CITY OF LOGAN
Active
Other names
Logan Manor Community Health services, Logan Mnaor Community Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA MCCOMB (ADMINISTRATOR)
(785) 689-4201
Entity
Organization
Contact information
Practice address
415 NORTH WASHINGTON ST, LOGAN, KS 67646-5115
(785) 689-4201
(785) 689-7411
Mailing address
108 S. ADAMS ST., PO BOX 308, LOGAN, KS 67646
(785) 689-4201
(785) 689-7411
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
N074003
KS
310400000X
Assisted Living Facility
N074001
KS
314000000X
Skilled Nursing Facility
Primary
N074001
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014001
OCCUPATIONAL THERAPIST
KS
05
—
100071510B
—
KS
05
—
100109100A
—
KS
01
—
115675
PHYSICAL THERAPIST
KS
01
—
140915
PHYSICAL THERAPIST
KS
01
—
A-074-005
STATE OF KANSAS HOME HEALTH AGENCY
KS
Enumeration date
09/20/2006
Last updated
11/18/2024
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