Provider Demographics
NPI:1316486467
Name:CHAPLAINCY CARE NETWORK
Entity type:Organization
Organization Name:CHAPLAINCY CARE NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:310-936-7703
Mailing Address - Street 1:10747 MAGNOLIA BLVD
Mailing Address - Street 2:418
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-4093
Mailing Address - Country:US
Mailing Address - Phone:310-936-7703
Mailing Address - Fax:
Practice Address - Street 1:323 N PRAIRIE AVE
Practice Address - Street 2:SUITE 417
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4502
Practice Address - Country:US
Practice Address - Phone:310-686-8490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty