MEDICARE: HARBOR AREA COUNSELING SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1508012824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARBOR AREA COUNSELING SERVICES, INC

Provider Business Mailing Address
First Line	:	624 W 9TH ST
Second Line	:	202
City	:	SAN PEDRO
State	:	CA
Zip	:	90731-3158
Country	:	US
Telephone Number	:	310-831-0006
Fax Number	:	310-831-0004

Provider Business Practice Location Address
First Line	:	624 W 9TH ST
Second Line	:	202
City	:	SAN PEDRO
State	:	CA
Zip	:	90731-3158
Country	:	US
Telephone Number	:	310-831-0006
Fax Number	:	310-831-0004

Authorized Official
Title or Position	:	CFO
Name	:	MR. DARIO L GHIO
Credential	:
Telephone Number	:	310-831-0006

Provider Enumeration Date	:	08/18/2008
Last Update Date	:	02/24/2017

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