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General NPI Number Information
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NPI Number | 1740543495
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Entity Type | Organization
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Legal Business Name | HARBOR HOUSE
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Dates
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Enumeration Date | 06/18/2012
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Last Update Date | 06/18/2012
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Provider Practice Location Address
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Address Line | 10 MOON ST APT. #2
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City | BOSTON
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State | MA
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Zip | 02113-2002
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Country | US
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Telephone | 781-264-2920
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Fax |
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Provider Business Mailing Address
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Address Line | 10 MOON ST #2
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City | BOSTON
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State | MA
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Zip | 02113-2002
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Country | US
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Telephone | 781-264-2920
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MICHELLE PUSATERI
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Credential | M.S. , CCC
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Telephone | 781-264-2920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 7278
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License Number State | MA
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