Provider Demographics
NPI:1780455501
Name:HARMONY HEALTH CENTER PERRIS LLC
Entity type:Organization
Organization Name:HARMONY HEALTH CENTER PERRIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:KERSHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-859-2742
Mailing Address - Street 1:6650 GUNPARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-7003
Mailing Address - Country:US
Mailing Address - Phone:303-468-0020
Mailing Address - Fax:303-568-7753
Practice Address - Street 1:305 E 4TH ST STE 100
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-2279
Practice Address - Country:US
Practice Address - Phone:303-468-0020
Practice Address - Fax:303-568-7753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-10
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder