Healthcare Provider Details

I. General information

NPI: 1033037528
Provider Name (Legal Business Name): HARBORWELL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 WINDHAM CT
GOLDSBORO NC
27530-9162
US

IV. Provider business mailing address

PO BOX 10412
GOLDSBORO NC
27532-0412
US

V. Phone/Fax

Practice location:
  • Phone: 919-330-7261
  • Fax:
Mailing address:
  • Phone: 919-330-7261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: IMARI ANYALI
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 919-330-7261