Provider Demographics
NPI:1083637979
Name:HARBOR HOUSE ENTERPRISES, LLC
Entity Type:Organization
Organization Name:HARBOR HOUSE ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADULT FAMILY CARE HOME ADMINISTRATO
Authorized Official - Prefix:MS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:561-315-3821
Mailing Address - Street 1:1090 CORAL WAY
Mailing Address - Street 2:
Mailing Address - City:SINGER ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33404-2709
Mailing Address - Country:US
Mailing Address - Phone:561-386-0522
Mailing Address - Fax:
Practice Address - Street 1:2626 LAKE DR STE 100
Practice Address - Street 2:SUITE 100
Practice Address - City:SINGER ISLAND
Practice Address - State:FL
Practice Address - Zip Code:33404-3846
Practice Address - Country:US
Practice Address - Phone:561-863-0522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL177F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes177F00000XOther Service ProvidersLodgingGroup - Single Specialty