Provider Demographics
NPI:1730623307
Name:HARMONY SENIOR SERVICE INC
Entity type:Organization
Organization Name:HARMONY SENIOR SERVICE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOATWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-844-1467
Mailing Address - Street 1:PO BOX 754
Mailing Address - Street 2:2120 U.S 1 SOUTH SUITE 112
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32085-0754
Mailing Address - Country:US
Mailing Address - Phone:904-844-1467
Mailing Address - Fax:
Practice Address - Street 1:809 PEARL ST
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-9542
Practice Address - Country:US
Practice Address - Phone:904-844-1467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL234434251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health