Provider Demographics
NPI:1972666006
Name:HARBOUR PRIVATE DUTY NURSING, LLC
Entity type:Organization
Organization Name:HARBOUR PRIVATE DUTY NURSING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SKEMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-895-8188
Mailing Address - Street 1:1950 LEE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-1859
Mailing Address - Country:US
Mailing Address - Phone:407-895-8188
Mailing Address - Fax:407-895-9339
Practice Address - Street 1:1950 LEE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-1859
Practice Address - Country:US
Practice Address - Phone:407-895-8188
Practice Address - Fax:407-895-9339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299991382251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health