NPI 1568507911

Maryhaven Center of Hope INC.

Organisation Intellectual Disabilities Intermediate Care Facility Port Jefferson, NY

Practice location

Address: 450 Myrtle Avenue House a, Port Jefferson, NY 11777
Phone: (631) 474-3400
Fax: (631) 474-4181
Mailing address: 51 Terryville Road, Port Jefferson Station, NY 11776

Authorised official

Name: Laura Pepper
Title: Director of Finance
Phone: (531) 474-4120

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 6639493 (NY)

Other Intermediate Care Facility, Intellectual Disabilities providers in New York →

Registry record

NPI: 1568507911
Entity type: Organization
NPI issued: 21 Feb 2007
Record last updated: 30 Apr 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.