NPIMap

Organization Active NPI

Harbor House, Inc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Goldsboro, NC
National Provider Identifier
1740469022
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
HARBOR HOUSE, INC
Practice address
2822 Cashwell Dr # 178
Goldsboro, NC 27534-4302
Phone
(919) 581-3592
Fax
(919) 734-8310
NPI assigned
Nov 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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) 252-1868

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

2822 Cashwell Dr # 178
Goldsboro, NC 27534-4302

Mailing address

203 N Jackson St
Goldsboro, NC 27530-3857
Phone (919) 581-3592

Other identifiers 7

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

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": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193961600000",
    "number": "1740469022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N JACKSON ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275303857",
            "telephone_number": "919-581-3592",
            "fax_number": "919-734-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2822 CASHWELL DR # 178",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275344302",
            "telephone_number": "919-581-3592",
            "fax_number": "919-734-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR HOUSE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2007-11-02",
        "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": "919-252-1868",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "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": "8301266B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301626",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301627B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301627",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301266",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Nov 2, 2007; 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.