Harbor Health Integrated Care LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HARBOR HEALTH INTEGRATED CARE LLC

Practice address

1717 W Northern Ave Ste 200
Phoenix, AZ 85021-5478

Phone

(888) 900-8082

NPI assigned

May 7, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Johnwick NathanNPI 1306327770

Title

Owner

Phone

(888) 900-8082

Specialties & licenses 5

Addresses

Electronic endpoints 1

Locations

Practitioners 1

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

• Johnwick Nathan

  • Substance Abuse Rehabilitation Facility
  • Laveen, AZ
  • NPI 1306327770
  NPD Authorized official

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598832000000",
    "number": "1831711258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W NORTHERN AVE STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850215478",
            "telephone_number": "888-900-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W NORTHERN AVE STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850215478",
            "telephone_number": "888-900-8082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR HEALTH INTEGRATED CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-07",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "NATHAN",
        "authorized_official_first_name": "JOHNWICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-900-8082",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "email",
            "affiliation": "N",
            "endpointDescription": "server",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "emr",
            "address_1": "1717 W Northern Ave Ste 200",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850215478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dana Harb, MD
• Julie Marie Harbo, D.V.M.
• Harbor Health
• Harbor Health Integrated Care Clinic
• Harbor Health Integrated Care Clinic
• Jeanette Renee Harbour, RN
• Hard Rock Recovery Center LLC
• Tiffany Etheredge Hardaway, M.D.
• Brandy N Harden, LCSW
• Chelsea Harden, CTRS

• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.