| Safe Harbor Mental Health | |
|
33 Jacks Ln Somerset KY 42501-6152 | |
| (606) 679-0014 | |
| (606) 679-0024 |
| Full Name | Safe Harbor Mental Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 33 Jacks Ln, Somerset, Kentucky |
| Authorized Official Name and Position | Katherine L Tillery (OWNER) |
| Authorized Official Contact | 8598688186 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Safe Harbor Mental Health 33 Jacks Ln Somerset KY 42501-6152 Ph: (606) 679-0014 | Safe Harbor Mental Health 33 Jacks Ln Somerset KY 42501-6152 Ph: (606) 679-0014 |
| NPI Number | 1679042279 |
|---|---|
| Provider Enumeration Date | 11/13/2018 |
| Last Update Date | 11/13/2018 |
| Medicare PECOS PAC ID | 1557607652 |
|---|---|
| Medicare Enrollment ID | O20190110001620 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679042279 | NPI | - | NPPES |
| 1992721773 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Katherine H Tillery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992721773 PECOS PAC ID: 1951472406 Enrollment ID: I20080611000471 |
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