MEDICARE: HARBOUR HOUSE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1942879648
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARBOUR HOUSE, INC

Provider Business Mailing Address
First Line	:	15 OAK CT
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-7017
Country	:	US
Telephone Number	:	410-255-3539
Fax Number	:	443-378-3540

Provider Business Practice Location Address
First Line	:	8350 WOODLAND RD
Second Line	:
City	:	MILLERSVILLE
State	:	MD
Zip	:	21108-1701
Country	:	US
Telephone Number	:	410-255-3539
Fax Number	:	443-378-3540

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. RODNEY MAURICE LAWS
Credential	:
Telephone Number	:	410-255-3539

Provider Enumeration Date	:	06/18/2021
Last Update Date	:	06/18/2021

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Directions to “HARBOUR HOUSE, INC ” Practice Location

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