11D2145558 CLIA NUMBER - HARBOR SPRINGS COUNSELING SERVICES

Laboratory Demographics

CLIA Number: 11D2145558

Facility Name: HARBOR SPRINGS COUNSELING SERVICES

Facility Address:
1790 MULKEY ROAD, SUITE A
AUSTELL, GA
ZIP 30106
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Facility Phone Number: 404 271-8768

Facility Type: Comp. Outpatient Rehab Facility

Certificate Type: Waiver

NPI Number: 1154889665

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	11D2145558
LAB Type	Comp. Outpatient Rehab Facility
Facility Name	HARBOR SPRINGS COUNSELING SERVICES
Street	1790 MULKEY ROAD, SUITE A
City	AUSTELL
State	GA
ZIP	30106
Phone	404 271-8768
CertificateType	4
CertificateEffectiveDate	3/12/2024
CertificateExpirationDate	3/11/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024