MEDICARE: HARBORLIGHT COMMUNITY PARTNERS

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	:	1992825210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARBORLIGHT COMMUNITY PARTNERS

Provider Business Mailing Address
First Line	:	221 CABOT ST
Second Line	:
City	:	BEVERLY
State	:	MA
Zip	:	01915-5718
Country	:	US
Telephone Number	:	978-922-9775
Fax Number	:	978-922-2874

Provider Business Practice Location Address
First Line	:	1 MONUMENT SQ
Second Line	:
City	:	BEVERLY
State	:	MA
Zip	:	01915-4539
Country	:	US
Telephone Number	:	978-922-9775
Fax Number	:	978-922-2874

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. ANDREW J DEFRANZA
Credential	:
Telephone Number	:	978-922-9775

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	05/05/2009

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