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General NPI Number Information
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NPI Number | 1447432315
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Entity Type | Organization
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Legal Business Name | HARBOR HOUSE ENTERPRISES LLC
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Dates
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Enumeration Date | 12/03/2007
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | 1090 CORAL WAY
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City | SINGER ISLAND
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State | FL
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Zip | 33404-2709
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Country | US
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Telephone | 561-842-5662
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Fax | 561-842-6360
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Provider Business Mailing Address
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Address Line | 1090 CORAL WAY
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City | SINGER ISLAND
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State | FL
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Zip | 33404-2709
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Country | US
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Telephone | 561-842-6360
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. DARLENE D HUDSON
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Credential | CRNA
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Telephone | 561-842-5662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | PENDING
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License Number State | FL
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