Organization
LOGAN COMMUNITY RESOURCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT MCFARLAND (CONTRACT SPECIALIST)
(574) 289-4831
Entity
Organization
Contact information
Practice address
2001 NILES AVE, SAINT JOSEPH, MI 49085-1614
(269) 983-5833
Mailing address
2505 E JEFFERSON BLVD, SOUTH BEND, IN 46615-2635
(574) 289-4831
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-19064
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-15-19064
BCBA
MI
Enumeration date
07/10/2015
Last updated
07/10/2015
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