Provider Demographics
NPI:1447432315
Name:HARBOR HOUSE ENTERPRISES LLC
Entity Type:Organization
Organization Name:HARBOR HOUSE ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:D
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:561-842-5662
Mailing Address - Street 1:1090 CORAL WAY
Mailing Address - Street 2:
Mailing Address - City:SINGER ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33404-2709
Mailing Address - Country:US
Mailing Address - Phone:561-842-6360
Mailing Address - Fax:
Practice Address - Street 1:1090 CORAL WAY
Practice Address - Street 2:
Practice Address - City:SINGER ISLAND
Practice Address - State:FL
Practice Address - Zip Code:33404-2709
Practice Address - Country:US
Practice Address - Phone:561-842-5662
Practice Address - Fax:561-842-6360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPENDING311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home