Provider Demographics
NPI:1760753198
Name:HARMONIUM
Entity Type:Organization
Organization Name:HARMONIUM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:REISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-837-2262
Mailing Address - Street 1:9245 ACTIVITY RD
Mailing Address - Street 2:SUITE105
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-4441
Mailing Address - Country:US
Mailing Address - Phone:858-684-3080
Mailing Address - Fax:
Practice Address - Street 1:5275 MARKET ST
Practice Address - Street 2:SUITE E
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92114-2212
Practice Address - Country:US
Practice Address - Phone:619-857-6799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 12382251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health