| Blue Harbor Counseling Services, L.l.c. | |
|
1617 25th Ave # 203 Gulfport MS 39501-2834 | |
| (228) 255-8553 | |
| Not Available |
| Full Name | Blue Harbor Counseling Services, L.l.c. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1617 25th Ave # 203, Gulfport, Mississippi |
| Authorized Official Name and Position | Vicki Arlene Blaize (OWNER) |
| Authorized Official Contact | 2283255855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Harbor Counseling Services, L.l.c. Po Box 7707 Diberville MS 39540-7602 Ph: (228) 325-5855 | Blue Harbor Counseling Services, L.l.c. 1617 25th Ave # 203 Gulfport MS 39501-2834 Ph: (228) 255-8553 |
| NPI Number | 1124602719 |
|---|---|
| Provider Enumeration Date | 05/10/2021 |
| Last Update Date | 01/25/2023 |
| Certification Date | 01/25/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124602719 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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