Healthcare Provider Details

I. General information

NPI: 1720345317
Provider Name (Legal Business Name): HARBOR HOMES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2012
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
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
03062-3128
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number850000244
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number850000244
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number850000244
License Number StateNH
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number100
License Number StateNH
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number850000244
License Number StateNH
# 6
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number850000244
License Number StateNH
# 7
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number850000244
License Number StateNH

VIII. Authorized Official

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