1396524617 NPI number — HARBOR HOMES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396524617 NPI number — HARBOR HOMES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARBOR HOMES, 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:
1396524617
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
77 NORTHEASTERN BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHUA
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03062-3128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-882-3616
Provider Business Mailing Address Fax Number:
603-595-7414

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 WINTER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NASHUA
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03064-5601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-882-3616
Provider Business Practice Location Address Fax Number:
603-595-7414
Provider Enumeration Date:
09/26/2023

Additional Information

Authorized Official

Authorized Official Last Name:
OCH
Authorized Official First Name:
HENRY
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT AND CEO
Authorized Official Telephone Number:
603-882-3616

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QC1500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00709 . This is a "COMMUNITY RESIDENCE LICENSE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




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