Healthcare Provider Details

I. General information

NPI: 1396524617
Provider Name (Legal Business Name): HARBOR HOMES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 WINTER ST
NASHUA NH
03064-5601
US

IV. Provider business mailing address

77 NORTHEASTERN BLVD
NASHUA NH
03062-3128
US

V. Phone/Fax

Practice location:
  • Phone: 603-882-3616
  • Fax: 603-595-7414
Mailing address:
  • Phone: 603-882-3616
  • Fax: 603-595-7414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

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