Healthcare Provider Details

I. General information

NPI: 1275224560
Provider Name (Legal Business Name): HARBOR HOME HEALTH LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 N VALLEY MILLS DR STE 306
WACO TX
76710-6076
US

IV. Provider business mailing address

3406 COLLEGE ST STE 200
BEAUMONT TX
77701-4612
US

V. Phone/Fax

Practice location:
  • Phone: 210-218-4290
  • Fax: 254-730-7256
Mailing address:
  • Phone: 409-730-2046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KAREN CARTER
Title or Position: EXEC ADMIN ASST
Credential:
Phone: 409-730-2046