NPIMap

Organization Active NPI

Harbor Health Services Inc

  • Home Health Agency
  • Marine City, MI
National Provider Identifier
1245220359
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
N/A
Legal business name
HARBOR HEALTH SERVICES INC
Practice address
1100 Degurse Ave
Marine City, MI 48039-3807
Phone
(810) 765-7144
Fax
(810) 765-9295
NPI assigned
Oct 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Authorized official

Name
Shefali Thaker
Title
Ceo
Phone
(810) 765-7144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X N/A Primary

Addresses

Primary practice location

1100 Degurse Ave
Marine City, MI 48039-3807

Mailing address

1100 Degurse Ave
Marine City, MI 48039-3807
Phone (810) 765-7144

Other identifiers 1

IdentifierTypeStateIssuer
3423421MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100513000400 MI Part A Provider - Home Health Agency 4385772235 Practice locations: Marine City, MI

Home health agency certification: CCN 237430

Legal name
HARBOR HEALTH SERVICES INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 25, 1997
Last certification
Feb 11, 2016
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jun 24, 1996 in MI
Enrollment address
1100 Degurse Ave
Marine City, MI 48039-3807

Care Compare: Home health agency

Medicare Care Compare
Listed as
Harbor Health Services, IncCCN 237430
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Jul 25, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Shefali Pankajkumar Thaker Individual 5% Or Greater Direct Ownership Interest Nov 16, 2022 100%
Corporate Officer Jul 1, 2022
Corporate Director Jul 1, 2022
W-2 Managing Employee Jul 1, 2022
Operational/Managerial Control Jul 1, 2022

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683072000000",
    "number": "1245220359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 DEGURSE AVE",
            "city": "MARINE CITY",
            "state": "MI",
            "postal_code": "480393807",
            "telephone_number": "810-765-7144",
            "fax_number": "810-765-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 DEGURSE AVE",
            "city": "MARINE CITY",
            "state": "MI",
            "postal_code": "480393807",
            "telephone_number": "810-765-7144",
            "fax_number": "810-765-9295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-28",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A",
        "authorized_official_last_name": "THAKER",
        "authorized_official_first_name": "SHEFALI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "810-765-7144"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3423421",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marine City, MI

Sources for this page

Verify at the official NPI Registry.