NPI 1043354681
Maryhaven Center of Hope INC.
Practice location
- Address
- 450 Myrtle Avenue House 1, Port Jefferson, NY 11777
- Phone
- (631) 331-6186
- Fax
- (631) 331-3974
- Mailing address
- 51 Terryville Road, Port Jefferson Station, NY 11776
Authorised official
- Name
- Laura Pepper
- Title
- Director of Finance
- Phone
- (631) 474-4120
Registered specialties
Intellectual Disabilities Intermediate Care Facility
Primary
Registry record
- NPI
- 1043354681
- Entity type
- Organization
- NPI issued
- 16 Feb 2007
- Record last updated
- 1 May 2015
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.