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Maryhaven Center Of Hope Inc.
Intellectual Disabilities Intermediate Care Facility in Port Jefferson, New York
NPI 1487799094

Maryhaven Center Of Hope Inc. is a Intellectual Disabilities Intermediate Care Facility based in Port Jefferson Station, NY. Maryhaven Center Of Hope Inc. practices in Port Jefferson, NY. The NPI Number for Maryhaven Center Of Hope Inc. is 1487799094 and holds a License No. 6639495 (New York).

The current practice location address for Maryhaven Center Of Hope Inc. is 450 Myrtle Avenue, Port Jefferson, NY and can be reached out via phone at 631-474-3400 and via fax at 631-474-4181.

Location: 450 Myrtle Avenue, Port Jefferson, NY, 11776
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1487799094
Provider Name
Maryhaven Center Of Hope Inc.
Credential
Provider Entity Type
Organization
Address
450 Myrtle Avenue, Port Jefferson, NY, 11776
Phone Number
631-474-3400
Fax Number
631-474-4181
Provider Enumeration Date
02/21/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
01042048 05 NY
institution
Provider Business Practice Location Address Details
Address
450 Myrtle Avenue
City
Port Jefferson
State
New York
Zip
11777
Phone Number
631-474-3400
Fax Number
631-474-4181
person
Provider Business Mailing Address Details
Address
450 Myrtle Avenue
City
Port Jefferson
State
New York
Zip
11777
Phone Number
631-474-3400
Fax Number
631-474-4181
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
6639495 (New York)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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