HARBOR HEALTHCARE INC NPI 1023146446

Intermediate Care Facility, Mentally Retarded in La Mirada, CA

About HARBOR HEALTHCARE INC

Harbor Healthcare Inc is a provider in La Mirada, CA. The NPI number assigned to this provider is 1023146446. The practitioner's primary taxonomy code is Intermediate Care Facility, Mentally Retarded (315P00000X). The provider is registered as an organization and their NPI record was last updated 11 years ago. The provider's is doing business as Neargrove Division.

NPI

1023146446

Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameHARBOR HEALTHCARE INC
Provider Location Address14203 NEARGROVE RD LA MIRADA, CA 90638 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address16917 CLARK AVE BELLFLOWER, CA 90706 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Other Organization NameNEARGROVE DIVISION Additional informationCallout TooltipProvider other organization name
The alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. Codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Other Name TypeDoing Business As (3)
Enumeration Date02-28-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date07-08-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Primary Taxonomy

Taxonomy Code315P00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationIntermediate Care Facility, Mentally Retarded
TypeNursing & Custodial Care Facilities
Taxonomy Description(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.

Business Address

HARBOR HEALTHCARE INC
14203 NEARGROVE RD
LA MIRADA, CA
ZIP 90638
Phone: (562) 866-7054
Fax: (562) 867-8053

Get Directions

Mailing Address

HARBOR HEALTHCARE INC
16917 CLARK AVE
BELLFLOWER, CA
ZIP 90706
Phone: (562) 866-7054
Fax: (562) 867-8053

Authorized Official

Authorized Official NameMRS. CHERYL LOFLIN WERTZ Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitleCEO
Authorized Official Phone(562) 866-7054

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
LTC60701GMEDICAID (05)CA
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