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General NPI Number Information
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NPI Number | 1689147605
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Entity Type | Organization
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Legal Business Name | LOGOS COMMUNITY DEVELOPMENT CORPORATION
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Dates
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Enumeration Date | 01/03/2019
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Last Update Date | 01/05/2019
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Provider Practice Location Address
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Address Line | 20 FLEMING ST
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City | HARRINGTON
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State | DE
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Zip | 19952-1995
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Country | US
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Telephone | 302-349-2779
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Fax | 302-450-7253
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Provider Business Mailing Address
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Address Line | 19 LIBERTY DR
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City | DOVER
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State | DE
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Zip | 19904-2641
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Country | US
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Telephone | 302-727-6750
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Fax |
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Authorized Official
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Title or Position | DR.
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Name | DR. TENESHIA TIFFANY WINDER
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Credential | PH.D
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Telephone | 302-349-2779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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