| Harbor House, Incorporated | |
|
615 N 19th St Fort Smith AR 72901-3319 | |
| (479) 785-4083 | |
| (479) 668-2059 |
| Full Name | Harbor House, Incorporated |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 615 N 19th St, Fort Smith, Arkansas |
| Authorized Official Name and Position | Ranee Lewis (OFFICE MANAGER) |
| Authorized Official Contact | 4797854083 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Harbor House, Incorporated Po Box 4207 Fort Smith AR 72914-4207 Ph: (479) 785-4083 | Harbor House, Incorporated 615 N 19th St Fort Smith AR 72901-3319 Ph: (479) 785-4083 |
| NPI Number | 1922166123 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 09/27/2023 |
| Certification Date | 09/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922166123 | NPI | - | NPPES |
| 236252526 | Medicaid | AR | |
| 239197526 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Primary |
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