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General NPI Number Information
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NPI Number | 1679461545
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Entity Type | Organization
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Legal Business Name | HARRIET RESIDENTIAL CARE, LLC
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Dates
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Enumeration Date | 06/27/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 1520 TUBMAN RD SE
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City | WASHINGTON
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State | DC
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Zip | 20020-2958
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Country | US
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Telephone | 888-886-7662
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Fax | 888-886-7662
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Provider Business Mailing Address
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Address Line | 7901 4TH ST N STE 300
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone | 321-490-5599
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. ZACHER BAYONNE
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Credential |
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Telephone | 301-573-0875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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