MEDICARE: HARBOR HOME HEALTH LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1275224560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARBOR HOME HEALTH LP

Provider Business Mailing Address
First Line	:	3406 COLLEGE ST STE 200
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77701-4612
Country	:	US
Telephone Number	:	409-730-2046
Fax Number	:

Provider Business Practice Location Address
First Line	:	510 N VALLEY MILLS DR STE 306
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76710-6076
Country	:	US
Telephone Number	:	210-218-4290
Fax Number	:	254-730-7256

Authorized Official
Title or Position	:	EXEC ADMIN ASST
Name	:	KAREN CARTER
Credential	:
Telephone Number	:	409-730-2046

Provider Enumeration Date	:	05/17/2023
Last Update Date	:	07/21/2023

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