Provider Demographics
NPI:1093284598
Name:SAFE HARBOR RECOVERY AND COUNSELING LLC
Entity Type:Organization
Organization Name:SAFE HARBOR RECOVERY AND COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:769-223-3341
Mailing Address - Street 1:123 WESTOVER DR
Mailing Address - Street 2:
Mailing Address - City:HATTISBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402
Mailing Address - Country:US
Mailing Address - Phone:769-223-3341
Mailing Address - Fax:
Practice Address - Street 1:123 WESTOVER DR
Practice Address - Street 2:
Practice Address - City:HATTISBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1329
Practice Address - Country:US
Practice Address - Phone:769-223-3341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-14
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility