NPIMap

Organization Active NPI

Harbor Hall, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Petoskey, MI
National Provider Identifier
1649733148
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
HARBOR HALL, INC.
Practice address
114 Rush St
Petoskey, MI 49770-2920
Phone
(231) 347-5511
Fax
(231) 347-5422
NPI assigned
Apr 11, 2019
Last updated
Apr 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Authorized official

Name
Kayla Jane Pennington
Title
Assistant
Phone
(231) 347-5511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

114 Rush St
Petoskey, MI 49770-2920

Mailing address

704 Emmet St
Petoskey, MI 49770-2910
Phone (231) 347-5511

Other practice location 1

302 Orchard Ridge Drive
Petoskey, MI 49770
Phone (231) 347-5511

Other identifiers 1

IdentifierTypeStateIssuer
SA0240037MedicaidMI

National Provider Directory

National Provider Directory
Tax ID family
Harbor Hall Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1649733148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 EMMET ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702910",
            "telephone_number": "231-347-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 RUSH ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702920",
            "telephone_number": "231-347-5511",
            "fax_number": "231-347-5422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 Orchard Ridge Drive",
            "address_purpose": "LOCATION",
            "city": "Petoskey",
            "state": "MI",
            "postal_code": "49770",
            "country_code": "US",
            "telephone_number": "231-347-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HARBOR HALL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-11",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "PENNINGTON",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "ASSISTANT",
        "authorized_official_telephone_number": "231-347-5511"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SA0240037",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.