Organization
HARBOR HOUSE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLENDA WIGGINS JOHNSON BS (EXECUTIVE DIRECTOR)
(919) 252-1868
Entity
Organization
Contact information
Practice address
2822 CASHWELL DR # 178, GOLDSBORO, NC 27534-4302
(919) 581-3592
(919) 734-8310
Mailing address
203 N JACKSON ST, GOLDSBORO, NC 27530-3857
(919) 581-3592
(919) 734-8310
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804952
—
NC
05
—
7805075
—
NC
05
—
8301266
—
NC
05
—
8301266B
—
NC
05
—
8301626
—
NC
05
—
8301627
—
NC
05
—
8301627B
—
NC
Enumeration date
11/02/2007
Last updated
11/02/2007
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