| Name: | Harbor Counseling Services LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 25 Oct 2019 (5 years ago) |
| Entity Number: | 000-591-602 |
| Register Number: | 000591602 |
| County: | Shelby |
| Place of Formation: | Shelby County |
| Registered Office Mailing Address: | 519 ALTA VISTA DRCHELSEA, AL 35043 |
| Registered Office Mailing Address ZIP Code: | 35043 |
| Registered Office Street Address: | 5520 HIGHWAY 280 SUITE 4BIRMINGHAM, AL 35242 |
| Registered Office Street Address ZIP Code: | 35242 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730727272 | 2019-12-16 | 2019-12-16 | 519 ALTA VISTA DR, CHELSEA, AL, 350436237, US | 5520 HIGHWAY 280 STE 4, BIRMINGHAM, AL, 352422308, US | |||||||||||||||||||
|
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| Phone | +1 256-577-0217 |
Authorized person
| Name | NEELY HAYNES |
| Role | OWNER/OPERATOR |
| Phone | 2565770217 |
Taxonomy
| Taxonomy Code | 101Y00000X - Counselor |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 239201 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| HAYNES, NEELY | Agent | 5520 HIGHWAY 280 SUITE 4BIRMINGHAM, AL 35242 |
| Name | Role | Address |
|---|---|---|
| HAYNES, NEELY | Organizer | 5520 HIGHWAY 280 SUITE 4BIRMINGHAM, AL 35242 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
