Provider Demographics
NPI:1245220359
Name:HARBOR HEALTH SERVICES INC
Entity Type:Organization
Organization Name:HARBOR HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHEFALI
Authorized Official - Middle Name:
Authorized Official - Last Name:THAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-765-7144
Mailing Address - Street 1:1100 DEGURSE AVE
Mailing Address - Street 2:
Mailing Address - City:MARINE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48039-3807
Mailing Address - Country:US
Mailing Address - Phone:810-765-7144
Mailing Address - Fax:810-765-9295
Practice Address - Street 1:1100 DEGURSE AVE
Practice Address - Street 2:
Practice Address - City:MARINE CITY
Practice Address - State:MI
Practice Address - Zip Code:48039-3807
Practice Address - Country:US
Practice Address - Phone:810-765-7144
Practice Address - Fax:810-765-9295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3423421Medicaid
MI3423421Medicaid
MI237430Medicare UPIN