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Organization

PPPS III

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEVEN LOGAN PHD (CEO/OWNER)
(517) 977-0899
Entity
Organization

Contact information

Practice address
1010 N NIAGARA ST, SAGINAW, MI 48602-4359
(517) 977-0899
(517) 977-0939
Mailing address
1936 BRUCE B DOWNS BLVD # 66, WESLEY CHAPEL, FL 33544-9262
(517) 977-0899
(517) 977-0939

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
251S00000X
Community/Behavioral Health Agency
Primary
730056
MI
251S00000X
Community/Behavioral Health Agency
822577
MI
251S00000X
Community/Behavioral Health Agency
261QM0850X
Adult Mental Health Clinic/Center
261QP2300X
Primary Care Clinic/Center
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
18844330
MI
Enumeration date
12/26/2006
Last updated
12/23/2020
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