Organization
HARBOR HOUSE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLENDA WIGGINS JOHNSON (EXECUTIVE DIRECTOR)
(919) 736-2802
Entity
Organization
Contact information
Practice address
203 N JACKSON ST, GOLDSBORO, NC 27530-3857
(919) 734-8310
(919) 734-8310
Mailing address
2822 CASHWELL DR # 178, GOLDSBORO, NC 27534-4302
(919) 736-2802
(919) 736-2809
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-096-207
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301266
—
NC
Enumeration date
04/16/2008
Last updated
04/16/2008
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