HARBOR HEALTH (NPI# 1639799356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639799356 |
| Entity Type | Organization |
| Organization Name | HARBOR HEALTH |
| Practice Address |
3213 S 66th Ave Phoenix AZ 85043-1922 |
| Mailing Address |
1717 W Northern Ave Ste 200 Phoenix AZ 85021-5478 |
| Practice Telephone | 8889008082 |
| Mailing Telephone | 6232135356 |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2020-04-22 |
| Authorized Official Name | JOHNWICK NATHAN (PRESIDENT) |
| Authorized Official Telephone | 6232135356 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Harbor Health | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | HARBOR HEALTH AND SKINCARE LLC | 4221 Harborview Drive Nw #103, Gig Harbor, WA 98335 |
| Oregon Corporations, Companies and Business Names | HARBOR HEALTH CLINIC LLC | 3519 Ne 15th Ave #232, Portland, OR 97212 |
| Washington State Corporations | HARBOR HEALTH CLINIC LLC | 945 Hildebrand Lane #232, Bainbridge Island, WA 98110 |
| Massachusetts Corporations | HARBOR HEALTH GROUP, P.C. | 25 Duncan St., Gloucester, MA 01930 |
| Washington State Corporations | HARBOR HEALTH LLC | 3216 Judson St, Gig Harbor, WA 98335-1224 |
| System for Award Management (SAM) Entities | HARBOR HEALTH SERVICES, INC. | 1135 Morton St, Mattapan, MA 02126-2834 |
| Connecticut Business Registrations | HARBOR HEALTH SERVICES, INC. | 14 Sycamore Way, Branford, CT 06405 |
| System for Award Management (SAM) Entities | HARBOR HEALTHCARE AND REHAB CENTER | 301 Ocean View Blvd, Lewes, DE 19958-1269 |
| System for Award Management (SAM) Entities | HARBOR HEALTHCARE OF IRONTON | 1050 Clinton St, Ironton, OH 45638 |
| Street Address |
3213 S 66TH AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85043-1922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013558311 | Back To Life Incorporated | Residential Treatment Facility, Emotionally Disturbed Children | 6420 W Cocopah St, Phoenix, AZ 85043 | 2019-10-08 |
| 1962936112 | Christine B Santa Cruz | Specialist/Technologist | 8101 W. Hammond Ln., Phoenix, AZ 85043 | 2017-04-14 |
| 1558704809 | Valley Independent Residential LLC | Community Based Residential Treatment Facility, Mental Illness | 6408 W Gross Ave, Phoenix, AZ 85043 | 2013-04-16 |
| 1275811598 | Diamond Manor Adult Care | Custodial Care Facility | 7330 W. Getty Drive, Phoenix, AZ 85043 | 2011-08-03 |
| 1821312877 | Bertha Romero | Case Manager/Care Coordinator | 7315 W Jones Ave, Phx, AZ 85043 | 2010-03-19 |
| 1477705788 | Patrick Lynn Perryman | Psychologist | 7250 W Buckeye Rd, Phoenix, AZ 85043 | 2008-10-17 |
| 1891910246 | Sammie Trotter | Technician | 5025 S. 24th Ave, Phoenix, AZ 85043 | 2007-04-13 |
| 1780719617 | German Dobson Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 6650 W. Lower Buckeye Rd, Phoenix, AZ 85043 | 2007-02-22 |
| 1992713689 | Occupational Health Center of The Southwest Pa | Clinic/Center | 5340 West Buckeye Road, Suite 3, Phoenix, AZ 85043 | 2006-08-04 |
| 1972523710 | William A Crane Jr. | Family Medicine | 7953 W Chickasaw St, Phoenix, AZ 85043 | 2006-07-21 |
| Find all providers in zip 85043 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932726361 | Northstar Homecare LLC | Substance Abuse Rehabilitation Facility | 5239 S 33rd Dr, Phoenix, AZ 85041-7411 | 2020-07-01 |
| 1891312542 | Semper Fidelis Behavioral Health Care, LLC | Substance Abuse Rehabilitation Facility | 8020 N 17th Dr, Phoenix, AZ 85021-5217 | 2020-06-29 |
| 1558988246 | Cmj Recovery Az LLC | Substance Abuse Rehabilitation Facility | 4122 N 17th St Bldg A, Phoenix, AZ 85016-5922 | 2020-06-29 |
| 1720549009 | Rtc Management Group, LLC | Substance Abuse Rehabilitation Facility | 1340 E Desert Cove Ave, Phoenix, AZ 85020-1110 | 2019-03-28 |
| 1497227771 | Vogue Recovery Center Outpatient | Substance Abuse Rehabilitation Facility | 4122 N 17th St Bldg C, Phoenix, AZ 85016-5922 | 2018-12-26 |
| 1780155077 | Pb Medical Group of Arizona, LLC | Substance Abuse Rehabilitation Facility | 3000 N 91st Ave, Phoenix, AZ 85037-4037 | 2018-12-11 |
| 1144790460 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 6222 S. 13th Street, Phoenix, AZ 85042 | 2018-11-29 |
| 1891283149 | Bbc Whitton, LLC | Substance Abuse Rehabilitation Facility | 1106 E Whitton Ave, Phoenix, AZ 85014-5053 | 2018-04-23 |
| 1417456336 | Vogue Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 4122 N 17th St, Phoenix, AZ 85016-5922 | 2018-02-06 |
| 1992254338 | A Path of Resilience | Substance Abuse Rehabilitation Facility | 6102 S 37th Ln, Phoenix, AZ 85041-5021 | 2016-09-27 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.