Provider Demographics
NPI:1558434779
Name:HARVEST COUNSELING GROUP INC
Entity Type:Organization
Organization Name:HARVEST COUNSELING GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICKIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-485-4357
Mailing Address - Street 1:4216 FLAGSTAFF COVE
Mailing Address - Street 2:HARVEST COUNSELING GROUP INC
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46815-4417
Mailing Address - Country:US
Mailing Address - Phone:260-485-4357
Mailing Address - Fax:260-485-4357
Practice Address - Street 1:4216 FLAGSTAFF COVE
Practice Address - Street 2:HARVEST COUNSELING GROUP INC
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46815-4417
Practice Address - Country:US
Practice Address - Phone:260-485-4357
Practice Address - Fax:260-485-4357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)