Provider Demographics
NPI:1720345317
Name:HARBOR CARE HEALTH AND WELLNESS CENTER
Entity Type:Organization
Organization Name:HARBOR CARE HEALTH AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLEHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-882-3616
Mailing Address - Street 1:77 NORTHEASTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-3128
Mailing Address - Country:US
Mailing Address - Phone:603-882-3616
Mailing Address - Fax:603-595-7414
Practice Address - Street 1:615 AMHERST ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-1052
Practice Address - Country:US
Practice Address - Phone:603-881-4848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARBOR CARE HEALTH AND WELLNESS CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-19
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH850000244101YA0400X, 101YM0800X, 207R00000X, 2084P0800X, 261QF0400X, 363LP2300X
NH100101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty