Provider Demographics
NPI:1194887042
Name:HARRISON HOUSE, INC.
Entity type:Organization
Organization Name:HARRISON HOUSE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PAYER SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-368-0888
Mailing Address - Street 1:5105Q BACKLICK RD
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-6005
Mailing Address - Country:US
Mailing Address - Phone:703-256-6474
Mailing Address - Fax:703-256-1596
Practice Address - Street 1:5105Q BACKLICK RD
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-6005
Practice Address - Country:US
Practice Address - Phone:703-256-6474
Practice Address - Fax:703-256-1596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA343-02-029261QR0405X
VA343-02-001261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder