Healthcare Provider Details

I. General information

NPI: 1386149482
Provider Name (Legal Business Name): HARBOR HOMES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2018
Last Update Date: 03/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10-12 AMHERST ST
NASHUA NH
03064-0306
US

IV. Provider business mailing address

77 NORTHEASTERN BLVD
NASHUA NH
03062-3128
US

V. Phone/Fax

Practice location:
  • Phone: 603-821-7788
  • Fax: 603-821-5620
Mailing address:
  • Phone: 603-882-3616
  • Fax: 603-595-7414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JAMIE TIMMINS
Title or Position: CREDENTIALING/ CONTRACTING
Credential:
Phone: 603-882-3616