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Organization
HARBOR HEALTH INTEGRATED CARE LLC
Active
Organization
HARBOR HEALTH INTEGRATED CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHNWICK NATHAN (OWNER)
(888) 900-8082
Entity
Organization
Contact information
Practice address
1717 W NORTHERN AVE STE 200, PHOENIX, AZ 85021-5478
(888) 900-8082
Mailing address
1717 W NORTHERN AVE STE 200, PHOENIX, AZ 85021-5478
(888) 900-8082
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
NULL
261QM2500X
Medical Specialty Clinic/Center
—
NULL
261QX0100X
Occupational Medicine Clinic/Center
—
NULL
283Q00000X
Psychiatric Hospital
—
NULL
Other
Enumeration date
05/07/2020
Last updated
08/31/2020
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