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Organization
SAFE HARBOUR
Active
Organization
SAFE HARBOUR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARISE KIMBERLY FRASIER BHS/QP (PRESIDENT/CLINICAL DIRECTOR)
(910) 265-4666
Entity
Organization
Contact information
Practice address
13 EAST DR, JACKSONVILLE, NC 28546-8214
(910) 265-4666
Mailing address
13 EAST DR, JACKSONVILLE, NC 28546-8214
(910) 265-4666
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
05/13/2008
Last updated
05/13/2008
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