Provider Demographics
NPI:1689147605
Name:LOGOS COMMUNITY DEVELOPMENT CORPORATION
Entity Type:Organization
Organization Name:LOGOS COMMUNITY DEVELOPMENT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:TENESHIA
Authorized Official - Middle Name:TIFFANY
Authorized Official - Last Name:WINDER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:302-349-2779
Mailing Address - Street 1:19 LIBERTY DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-2641
Mailing Address - Country:US
Mailing Address - Phone:302-727-6750
Mailing Address - Fax:
Practice Address - Street 1:20 FLEMING ST
Practice Address - Street 2:
Practice Address - City:HARRINGTON
Practice Address - State:DE
Practice Address - Zip Code:19952-1995
Practice Address - Country:US
Practice Address - Phone:302-349-2779
Practice Address - Fax:302-450-7253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)