Healthcare Provider Details

I. General information

NPI: 1225064264
Provider Name (Legal Business Name): HARBOR HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 04/02/2020
Certification Date: 04/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 MORTON STREET
MATTAPAN MA
02126-2834
US

IV. Provider business mailing address

1135 MORTON STREET
MATTAPAN MA
02126-2834
US

V. Phone/Fax

Practice location:
  • Phone: 617-533-2400
  • Fax: 617-533-2401
Mailing address:
  • Phone: 617-533-2300
  • Fax: 617-533-2301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES T. JONES
Title or Position: PRESIDENT & CEO
Credential:
Phone: 617-533-2350