Provider Demographics
NPI:1407677990
Name:HARBORS NORTH LLC
Entity type:Organization
Organization Name:HARBORS NORTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHELLDORF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-445-1898
Mailing Address - Street 1:1 ALTAIR DR
Mailing Address - Street 2:
Mailing Address - City:BOYNE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49712-9618
Mailing Address - Country:US
Mailing Address - Phone:231-445-1898
Mailing Address - Fax:
Practice Address - Street 1:3890 CHARLEVOIX RD STE 210
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8420
Practice Address - Country:US
Practice Address - Phone:231-445-1898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty