# GLENMARK LIMITED LIABILITY COMPANY I

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Logan Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780620542
- **Authorized official:** JANE DROPESKEY (CORPORATE MANAGER)
- **Authorized official phone:** (610) 925-4231

## Contact information

- **Practice address:** ROUTE 10 THREE MILE CURVE, LOGAN, WV 25601
- **Practice address phone:** (304) 752-2273
- **Practice address fax:** (304) 752-4167
- **Mailing address:** 101 E STATE ST, KENNETT SQUARE, PA 19348-3109
- **Mailing address phone:** (610) 925-4436
- **Mailing address fax:** (610) 925-4351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 127 | WV | Yes |

## Other

- **Enumeration date:** 06/21/2006
- **Last updated:** 06/21/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0003060000 | — | WV |
| 01 | — | 001703861 | MOUNTAIN STATE | — |
| 01 | — | 281422 | UNITED-MAMSI | — |
| 01 | — | 3061641 | AETNA - HMO | — |