Provider Demographics
NPI:1164973129
Name:SAFE HARBOR HOMECARE LLC
Entity Type:Organization
Organization Name:SAFE HARBOR HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUCCIONE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:609-549-6435
Mailing Address - Street 1:364 N MAIN ST STE 6
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-3187
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:609-549-6509
Practice Address - Street 1:364 N MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-3187
Practice Address - Country:US
Practice Address - Phone:609-549-6435
Practice Address - Fax:609-549-6509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0229100251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health