Healthcare Provider Details

I. General information

NPI: 1992825210
Provider Name (Legal Business Name): HARBORLIGHT COMMUNITY PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 05/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MONUMENT SQ
BEVERLY MA
01915-4539
US

IV. Provider business mailing address

221 CABOT ST
BEVERLY MA
01915-5718
US

V. Phone/Fax

Practice location:
  • Phone: 978-922-9775
  • Fax: 978-922-2874
Mailing address:
  • Phone: 978-922-9775
  • Fax: 978-922-2874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDREW J DEFRANZA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 978-922-9775