Provider Demographics
NPI:1467128405
Name:HARBOR HEALTH AND WELLNESS, LLC
Entity Type:Organization
Organization Name:HARBOR HEALTH AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-240-8627
Mailing Address - Street 1:1778 MANASSAS DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-8023
Mailing Address - Country:US
Mailing Address - Phone:843-304-3259
Mailing Address - Fax:843-459-7949
Practice Address - Street 1:1778 MANASSAS DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-8023
Practice Address - Country:US
Practice Address - Phone:843-304-3259
Practice Address - Fax:843-459-7949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy