Provider Demographics
NPI:1730674342
Name:HARBOR CARE FOUNDATION, INC.
Entity Type:Organization
Organization Name:HARBOR CARE FOUNDATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:HACKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-646-2370
Mailing Address - Street 1:PO BOX 950220
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91395-0220
Mailing Address - Country:US
Mailing Address - Phone:818-925-1454
Mailing Address - Fax:818-361-0041
Practice Address - Street 1:11134 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1114
Practice Address - Country:US
Practice Address - Phone:818-925-1454
Practice Address - Fax:818-361-0041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-26
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility