| Harbor Of Hope Medical And Behavioral Health Care, Llc | |
|
185 Treuhaft Blvd Apt 4 Barbourville KY 40906-8300 | |
| (606) 545-6766 | |
| Not Available |
| Full Name | Harbor Of Hope Medical And Behavioral Health Care, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 185 Treuhaft Blvd Apt 4, Barbourville, Kentucky |
| Authorized Official Name and Position | Thelma J Gray (OWNER) |
| Authorized Official Contact | 6062693428 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harbor Of Hope Medical And Behavioral Health Care, Llc 868 Sam Parker Rd Gray KY 40734-6780 Ph: (606) 269-3428 | Harbor Of Hope Medical And Behavioral Health Care, Llc 185 Treuhaft Blvd Apt 4 Barbourville KY 40906-8300 Ph: (606) 545-6766 |
| NPI Number | 1235774522 |
|---|---|
| Provider Enumeration Date | 11/11/2019 |
| Last Update Date | 04/13/2020 |
| Certification Date | 04/13/2020 |
| Medicare PECOS PAC ID | 2769811397 |
|---|---|
| Medicare Enrollment ID | O20200402003220 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235774522 | NPI | - | NPPES |
| 7100615630 | Medicaid | KY |
| Provider Name | Thelma J Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548755499 PECOS PAC ID: 4587093117 Enrollment ID: I20200402003357 |
| Provider Name | Mary J Lang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013125160 PECOS PAC ID: 2466644380 Enrollment ID: I20210714001868 |
Harbor Of Hope Medical And Behavioral Health Care, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 185 Treuhaft Blvd, Ste 4, Barbourville, KY 40906 Phone: 606-545-6766 Fax: 606-545-0366 | |
Harbor Of Hope Medical And Behavioral Health Care, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 185 Treuhaft Blvd, Suite 4, Barbourville, KY 40906 Phone: 606-546-6766 Fax: 606-545-0366 | |
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