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Woodhaven Adult Home, Llc
Assisted Living Facility in Port Jefferson Station, New York
NPI 1609998681

Woodhaven Adult Home, Llc is an Assisted Living Facility based in Port Jefferson Station, NY. Woodhaven Adult Home, Llc practices in Port Jefferson Station, NY. The NPI Number for Woodhaven Adult Home, Llc is 1609998681 and holds a License No. 700-F-905 (New York).

The current practice location address for Woodhaven Adult Home, Llc is 1350 Route 112, Port Jefferson Station, NY and can be reached out via phone at 631-473-7100 and via fax at 631-473-7118.

Location: 1350 Route 112, Port Jefferson Station, NY, 11776-3078
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1609998681
Provider Name
Woodhaven Adult Home, Llc
Credential
Provider Entity Type
Organization
Address
1350 Route 112, Port Jefferson Station, NY, 11776-3078
Phone Number
631-473-7100
Fax Number
631-473-7118
Provider Enumeration Date
04/03/2007
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
02362614 05 NY
institution
Provider Business Practice Location Address Details
Address
1350 Route 112
City
Port Jefferson Station
State
New York
Zip
11776-3078
Phone Number
631-473-7100
Fax Number
631-473-7118
person
Provider Business Mailing Address Details
Address
1350 Route 112
City
Port Jefferson Station
State
New York
Zip
11776-3078
Phone Number
631-473-7100
Fax Number
631-473-7118
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
-
Taxonomy
310400000X
License No.
700-F-905 (New York)
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
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