Healthcare Provider Details

I. General information

NPI: 1609406891
Provider Name (Legal Business Name): HARBOR DE SNF MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2020
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 OCEAN VIEW BLVD
LEWES DE
19958-1269
US

IV. Provider business mailing address

7077 AV DU PARC SUITE 600
MONTREAL QUEBEC
H3N1X7
CA

V. Phone/Fax

Practice location:
  • Phone: 302-645-4664
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: AARON FRIEDMAN
Title or Position: MANAGER
Credential:
Phone: 514-777-3539