1386751428 NPI number — HARBOURVIEW CARE CENTER INC.

Table of content: (NPI 1386751428)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386751428 NPI number — HARBOURVIEW CARE CENTER INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARBOURVIEW CARE CENTER INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386751428
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/15/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2302 POST OFFICE ST
Provider Second Line Business Mailing Address:
SUITE 402
Provider Business Mailing Address City Name:
GALVESTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77550-1913
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
409-763-6000
Provider Business Mailing Address Fax Number:
709-770-0233

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 ENTERPRISE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEAGUE CITY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77573-2936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-334-4243
Provider Business Practice Location Address Fax Number:
281-334-4396
Provider Enumeration Date:
08/24/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
OSTERMAYER
Authorized Official First Name:
CAROL
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
409-763-6000

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  138015 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000528501 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".