# CITY OF LOGAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Logan Manor Community Health services, Logan Mnaor Community Health Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396842662
- **Authorized official:** TERESA MCCOMB (ADMINISTRATOR)
- **Authorized official phone:** (785) 689-4201

## Contact information

- **Practice address:** 415 NORTH WASHINGTON ST, LOGAN, KS 67646-5115
- **Practice address phone:** (785) 689-4201
- **Practice address fax:** (785) 689-7411
- **Mailing address:** 108 S. ADAMS ST., PO BOX 308, LOGAN, KS 67646
- **Mailing address phone:** (785) 689-4201
- **Mailing address fax:** (785) 689-7411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | N074003 | KS | — |
| 310400000X | Assisted Living Facility | N074001 | KS | — |
| 314000000X | Skilled Nursing Facility | N074001 | KS | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 11/18/2024

## 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 |