=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801737903
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HARBORCOVE HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/02/2026
-----------------------------------------------------
Last Update Date | 04/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3970 W 24TH ST STE 209
-----------------------------------------------------
City | YUMA
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85364-9263
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 928-304-9480
-----------------------------------------------------
Fax | 928-250-1591
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3970 W 24TH ST STE 209
-----------------------------------------------------
City | YUMA
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85364-9263
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 928-304-9480
-----------------------------------------------------
Fax | 928-250-1591
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JUSTIN HUTCHINS
-----------------------------------------------------
Credential | NP
-----------------------------------------------------
Telephone | 928-304-9480
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM2500X
-----------------------------------------------------
Taxonomy Name | Medical Specialty Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------