Organization
THE RANDOLPH LOGAN GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANAE LOGAN MS (CEO)
(610) 850-5001
Entity
Organization
Contact information
Practice address
2403 W WALNUT ST, COLMAR, PA 18915-9704
(484) 213-0043
Mailing address
600 W GERMANTOWN PIKE STE 400, PLYMOUTH MEETING, PA 19462-1046
(610) 850-5001
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
12/20/2023
Last updated
12/20/2023
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