Provider Demographics
NPI:1538304373
Name:HARBOR HEALTH LLC
Entity Type:Organization
Organization Name:HARBOR HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-945-3383
Mailing Address - Street 1:1724 CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-3315
Mailing Address - Country:US
Mailing Address - Phone:252-945-3383
Mailing Address - Fax:
Practice Address - Street 1:1724 CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-3315
Practice Address - Country:US
Practice Address - Phone:252-945-3383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
NCMHL-007-070261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health