Healthcare Provider Details

I. General information

NPI: 1548036585
Provider Name (Legal Business Name): HARBOR HOMES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2023
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 AMHERST ST
NASHUA NH
03063-1052
US

IV. Provider business mailing address

77 NORTHEASTERN BLVD
NASHUA NH
03062-3161
US

V. Phone/Fax

Practice location:
  • Phone: 603-881-4848
  • Fax: 603-598-3644
Mailing address:
  • Phone: 603-882-3616
  • Fax: 603-595-7414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: HENRY J OCH
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 603-882-3616