Provider Demographics
NPI:1710691514
Name:HARVEST HOUSE TRANSITIONAL RESIDENCE, INC.
Entity Type:Organization
Organization Name:HARVEST HOUSE TRANSITIONAL RESIDENCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TRENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOLLUMN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-577-7358
Mailing Address - Street 1:PO BOX 9063
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-9063
Mailing Address - Country:US
Mailing Address - Phone:707-888-4058
Mailing Address - Fax:
Practice Address - Street 1:146 CANDY DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-1403
Practice Address - Country:US
Practice Address - Phone:707-888-4058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No177F00000XOther Service ProvidersLodging
No251V00000XAgenciesVoluntary or Charitable
No253Z00000XAgenciesIn Home Supportive Care