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General NPI Number Information
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NPI Number | 1215068341
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Entity Type | Organization
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Legal Business Name | HARBOR HOUSE INC
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 203 N JACKSON ST
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City | GOLDSBORO
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State | NC
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Zip | 27530-3857
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Country | US
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Telephone | 919-734-8310
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Fax |
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Provider Business Mailing Address
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Address Line | 2822 CASHWELL DR # 178
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City | GOLDSBORO
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State | NC
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Zip | 27534-4302
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Country | US
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Telephone | 919-736-2802
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. GLENDA WIGGINS JOHNSON
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Credential | BS
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Telephone | 919-734-8310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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