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General NPI Number Information
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NPI Number | 1386556637
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Entity Type | Organization
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Legal Business Name | LOGAN HEIGHTS COMMUNITY DEVELOPMENT CORPORATION (CDC)
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Dates
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Enumeration Date | 09/21/2026
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Last Update Date | 09/21/2026
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Provider Practice Location Address
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Address Line | 3040 IMPERIAL AVE
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City | SAN DIEGO
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State | CA
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Zip | 92102-4128
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Country | US
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Telephone | 619-858-0563
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Fax | 619-858-0564
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Provider Business Mailing Address
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Address Line | 3040 IMPERIAL AVE
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City | SAN DIEGO
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State | CA
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Zip | 92102-4128
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Country | US
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Telephone | 619-858-0563
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Fax | 619-858-0564
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MONTE A JONES
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Credential | MBA
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Telephone | 619-858-0563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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