Organization
LOGAN COMMUNITY RESOURCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAN RYAN (DIR SONYA ANSARI CENTER FOR AUTISM)
(574) 289-4831
Entity
Organization
Contact information
Practice address
2505 E JEFFERSON BLVD, SOUTH BEND, IN 46615-2635
(574) 289-4831
(574) 234-2075
Mailing address
2505 E JEFFERSON BLVD, SOUTH BEND, IN 46615-2635
(574) 289-4831
(574) 234-2075
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-18324
IN
Other
Enumeration date
05/27/2015
Last updated
05/27/2015
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