Organization
SAFE HARBOR CLINIC LLC
Active
Other names
Safe Harbor Clinic LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUSTIN MARMALICH MD (OWNER)
(228) 424-4425
Entity
Organization
Contact information
Practice address
4013 BEATLINE RD STE A, LONG BEACH, MS 39560-4135
(228) 200-0720
Mailing address
4013 BEATLINE RD STE A, LONG BEACH, MS 39560-4135
(228) 200-0720
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
10/26/2018
Last updated
10/26/2018
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