Provider Demographics
NPI:1114048675
Name:HARBORSIDE REHABILITATION LP
Entity Type:Organization
Organization Name:HARBORSIDE REHABILITATION LP
Other - Org Name:READYNURSE STAFFING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:COCKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-276-4556
Mailing Address - Street 1:2602 HIGHLANDS BLVD N
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-2114
Mailing Address - Country:US
Mailing Address - Phone:800-276-4556
Mailing Address - Fax:727-786-6265
Practice Address - Street 1:2602 HIGHLANDS BLVD N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-2114
Practice Address - Country:US
Practice Address - Phone:800-276-4556
Practice Address - Fax:727-786-6265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL611251J00000X
MATZ9G251J00000X
RINPA00019251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care