Provider Demographics
NPI:1104358993
Name:HARBOR OF LOVE
Entity Type:Organization
Organization Name:HARBOR OF LOVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLC WELLNESS CARE
Authorized Official - Prefix:DR
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-639-1033
Mailing Address - Street 1:245 POWERS FERRY RD.
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067
Mailing Address - Country:US
Mailing Address - Phone:678-663-1827
Mailing Address - Fax:
Practice Address - Street 1:3950 FREY RD NW
Practice Address - Street 2:#216
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-5419
Practice Address - Country:US
Practice Address - Phone:678-663-1827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty