Provider Demographics
NPI:1194763813
Name:SNUG HARBOR HOME HEALTH,INC
Entity type:Organization
Organization Name:SNUG HARBOR HOME HEALTH,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-378-4389
Mailing Address - Street 1:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47356-0155
Mailing Address - Country:US
Mailing Address - Phone:765-378-4389
Mailing Address - Fax:765-378-4431
Practice Address - Street 1:9016 S COUNTY ROAD 800 W
Practice Address - Street 2:
Practice Address - City:DALEVILLE
Practice Address - State:IN
Practice Address - Zip Code:47334-9420
Practice Address - Country:US
Practice Address - Phone:765-378-4389
Practice Address - Fax:765-378-4431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities