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General NPI Number Information
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NPI Number | 1639654643
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Entity Type | Organization
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Legal Business Name | HARBOR HOMES, INC.
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Dates
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Enumeration Date | 09/26/2018
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Last Update Date | 09/26/2018
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Provider Practice Location Address
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Address Line | 17 BIRCH HILL DR
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City | NASHUA
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State | NH
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Zip | 03063-2541
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Country | US
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Telephone | 603-821-7788
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Fax | 603-821-5620
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Provider Business Mailing Address
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Address Line | 77 NORTHEASTERN BLVD
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City | NASHUA
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State | NH
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Zip | 03062-3128
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Country | US
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Telephone | 603-882-3616
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Fax | 866-881-9106
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Authorized Official
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Title or Position | CREDENTIALING/CONTRACTING
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Name | COLLEEN CANAWAY
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Credential |
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Telephone | 603-882-3616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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