Provider Demographics
NPI:1346517695
Name:HARBOR HOUSE MINISTRIES, INC
Entity Type:Organization
Organization Name:HARBOR HOUSE MINISTRIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY, BOARD OF DIRECTORS
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:VELTEMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-797-9920
Mailing Address - Street 1:919 44TH AVE
Mailing Address - Street 2:
Mailing Address - City:JENISON
Mailing Address - State:MI
Mailing Address - Zip Code:49428-9193
Mailing Address - Country:US
Mailing Address - Phone:616-797-9920
Mailing Address - Fax:616-797-9921
Practice Address - Street 1:919 44TH AVE
Practice Address - Street 2:
Practice Address - City:JENISON
Practice Address - State:MI
Practice Address - Zip Code:49428-9193
Practice Address - Country:US
Practice Address - Phone:616-797-9920
Practice Address - Fax:616-797-9921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAM700257038311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home