Organization
HARBOR VILLAGE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT GRANT NIZNIK J,D. (OWNER/CEO)
(855) 633-6130
Entity
Organization
Contact information
Practice address
9200 NW 8TH AVE, MIAMI, FL 33150-2016
(657) 304-0103
Mailing address
PO BOX 919598, ORLANDO, FL 32891-9598
(855) 633-6130
(305) 930-7437
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1113AD185301
FL
Other
Enumeration date
04/30/2013
Last updated
10/25/2022
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