Provider Demographics
NPI:1205641388
Name:COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY
Entity type:Organization
Organization Name:COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:BAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-599-1411
Mailing Address - Street 1:212 E COLUMBUS AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-2033
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9464 US HIGHWAY 36 STE 2
Practice Address - Street 2:
Practice Address - City:SAINT PARIS
Practice Address - State:OH
Practice Address - Zip Code:43072-9367
Practice Address - Country:US
Practice Address - Phone:937-599-1411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-07
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty