Healthcare Provider Details

I. General information

NPI: 1003728726
Provider Name (Legal Business Name): HARBOR HOUSE OF LOUISVILLE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2233 LOWER HUNTERS TRCE
LOUISVILLE KY
40216-1358
US

IV. Provider business mailing address

2233 LOWER HUNTERS TRCE
LOUISVILLE KY
40216-1358
US

V. Phone/Fax

Practice location:
  • Phone: 502-719-0922
  • Fax:
Mailing address:
  • Phone: 502-719-0922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARIA A SMITH
Title or Position: CEO
Credential:
Phone: 502-719-0072