| The Harbor On Main | |
|
150 S Main St Lakeport CA 95453-5017 | |
| (707) 994-5486 | |
| Not Available |
| Full Name | The Harbor On Main |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 150 S Main St, Lakeport, California |
| Authorized Official Name and Position | Victoria Jerusha Kelly (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7074672010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Harbor On Main Po Box 2077 Ukiah CA 95482-2077 Ph: (707) 467-2010 | The Harbor On Main 150 S Main St Lakeport CA 95453-5017 Ph: (707) 994-5486 |
| NPI Number | 1336387455 |
|---|---|
| Provider Enumeration Date | 01/27/2009 |
| Last Update Date | 02/12/2020 |
| Certification Date | 02/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336387455 | NPI | - | NPPES |
| 17CC | Other | CA | LAKE CO MH SITE # |
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