Healthcare Provider Details

I. General information

NPI: 1528698321
Provider Name (Legal Business Name): HARBOR VILLAGE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2020
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 STATE MARKET RD
PAHOKEE FL
33476-1542
US

IV. Provider business mailing address

1515 NW 167TH ST STE 430
MIAMI FL
33169-5147
US

V. Phone/Fax

Practice location:
  • Phone: 561-876-1498
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY BLAIR ELDER
Title or Position: RCM
Credential: PHD
Phone: 737-247-1223