NPIMap

Organization Active NPI

Harbor House Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Goldsboro, NC
National Provider Identifier
1215068341
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
HARBOR HOUSE INC
Practice address
203 N Jackson St
Goldsboro, NC 27530-3857
Phone
(919) 734-8310
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Glenda Wiggins Johnson, BS
Title
Executive Director
Phone
(919) 734-8310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

203 N Jackson St
Goldsboro, NC 27530-3857

Mailing address

2822 Cashwell Dr # 178
Goldsboro, NC 27534-4302
Phone (919) 736-2802

Other identifiers 6

IdentifierTypeStateIssuer
8301626MedicaidNC
8301627MedicaidNC
8301266BMedicaidNC
7804952MedicaidNC
7805075MedicaidNC
8301266MedicaidNC

Other names 1

  • Harbor House Of goldsboro Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Harbor House Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215068341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2822 CASHWELL DR # 178",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275344302",
            "telephone_number": "919-736-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 N JACKSON ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275303857",
            "telephone_number": "919-734-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR HOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_middle_name": "WIGGINS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-734-8310",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301626",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301627",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301266B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804952",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805075",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301266",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harbor House Of goldsboro",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.