Healthcare Provider Details

I. General information

NPI: 1235818501
Provider Name (Legal Business Name): HARBOR BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2023
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 DUKE RD
LEXINGTON KY
40502-2514
US

IV. Provider business mailing address

319 DUKE RD
LEXINGTON KY
40502-2514
US

V. Phone/Fax

Practice location:
  • Phone: 859-200-0580
  • Fax:
Mailing address:
  • Phone: 603-605-5757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW LEE COKER
Title or Position: CEO
Credential:
Phone: 405-255-3037