Provider Demographics
NPI:1437455524
Name:HARVESTIME ADMINISTRATIVE AND INSTRUCTIONAL SERVICES
Entity Type:Organization
Organization Name:HARVESTIME ADMINISTRATIVE AND INSTRUCTIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMYE
Authorized Official - Middle Name:RAYNOR
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:RN BS BSN
Authorized Official - Phone:336-684-7050
Mailing Address - Street 1:PO BOX 1444
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27216-1444
Mailing Address - Country:US
Mailing Address - Phone:336-684-7050
Mailing Address - Fax:
Practice Address - Street 1:3105 COMMERCE PL
Practice Address - Street 2:APT F
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5170
Practice Address - Country:US
Practice Address - Phone:336-684-7050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management