Healthcare Provider Details

I. General information

NPI: 1306701230
Provider Name (Legal Business Name): ANCHOR HEALTH HARBOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2025
Last Update Date: 12/23/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 JOHN MILLER WAY STE 326
KEARNY NJ
07032-6533
US

IV. Provider business mailing address

78 JOHN MILLER WAY STE 326
KEARNY NJ
07032-6533
US

V. Phone/Fax

Practice location:
  • Phone: 201-554-4333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: OLUFEMI ILORI
Title or Position: ADMINISTRATOR
Credential:
Phone: 201-554-4333