Provider Demographics
NPI:1346200136
Name:HARBOR HEALTH SERVICES INC
Entity Type:Organization
Organization Name:HARBOR HEALTH SERVICES INC
Other - Org Name:HARBOR FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DRISCOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-282-3200
Mailing Address - Street 1:398 NEPONSET AVENUE
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02122
Mailing Address - Country:US
Mailing Address - Phone:617-282-3200
Mailing Address - Fax:617-282-7928
Practice Address - Street 1:32 DEVINE WAY
Practice Address - Street 2:HARBOR FAMILY HEALTH CENTER
Practice Address - City:SOUTH BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-3534
Practice Address - Country:US
Practice Address - Phone:617-269-0312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA221851Medicare ID - Type Unspecified