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General NPI Number Information
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NPI Number | 1225192495
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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 | 12/21/2006
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Last Update Date | 09/11/2025
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Provider Practice Location 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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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | MHL096146
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License Number State | NC
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Taxonomy #2
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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 | MHL096171
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License Number State | NC
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Taxonomy #3
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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 | MHL096146
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License Number State | NC
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Taxonomy #4
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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 | MHL096170
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License Number State | NC
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