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General NPI Number Information
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NPI Number | 1952637779
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Entity Type | Organization
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Legal Business Name | HARVEST COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 10/29/2009
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Last Update Date | 10/29/2009
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Provider Practice Location Address
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Address Line | 4276 HARBOR BEACH BLVD D
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City | BRIGANTINE
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State | NJ
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Zip | 08203-1363
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Country | US
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Telephone | 609-266-2227
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Fax |
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Provider Business Mailing Address
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Address Line | 126 N BARTRAM AVE
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City | ATLANTIC CITY
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State | NJ
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Zip | 08401-3308
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Country | US
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Telephone | 609-266-2227
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Fax | 609-266-2229
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | MS. KATHRYN ADA CASSELBERRY
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Credential | CADC
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Telephone | 609-408-9488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 2000297-08
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License Number State | NJ
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