MARYHAVEN CENTER OF HOPE INC. (NPI# 1043354681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043354681 |
| Entity Type | Organization |
| Organization Name | MARYHAVEN CENTER OF HOPE INC. |
| Practice Address |
450 Myrtle Avenue House 1 Port Jefferson NY 11777 |
| Mailing Address |
51 Terryville Road Port Jefferson Station NY 11776 |
| Practice Telephone | 6313316186 |
| Practice Fax Number | 6313313974 |
| Mailing Telephone | 6314744120 |
| Mailing Fax Number | 6314741312 |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2015-05-01 |
| Authorized Official Name | LAURA PEPPER (DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 6314744120 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00883298 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164752101 | Maryhaven Center of Hope Inc. | Community/Behavioral Health | 179 Elmont Road, Elmont, NY 11003 | 2010-01-13 |
| 1306176342 | Maryhaven Center of Hope Inc. | Community/Behavioral Health | 64 N Corona Avenue, Valley Stream, NY 11580 | 2010-01-13 |
| 1003146119 | Maryhaven Center of Hope Inc. | Community/Behavioral Health | 2957 Burns Avenue, Wantagh, NY 11793 | 2010-01-12 |
| 1417149386 | Maryhaven Center of Hope Inc. | Clinic/Center | 445 County Road 101, Yaphank, NY 11980 | 2007-08-15 |
| 1437294451 | Maryhaven Center of Hope Inc. | Intermediate Care Facility, Mentally Retarded | 9 Miller Place Road, Miller Place, NY 11764 | 2007-02-20 |
| 1225172521 | Maryhaven Center of Hope Inc. | Intermediate Care Facility, Mentally Retarded | 1385 N Ocean Avenue, Medford, NY 11763 | 2007-02-19 |
| 1134263429 | Maryhaven Center of Hope Inc. | Intermediate Care Facility, Mentally Retarded | 452 Miller Place Road, Miller Place, NY 11764 | 2007-02-19 |
| 1013051341 | Maryhaven Center of Hope Inc. | Intermediate Care Facility, Mentally Retarded | 298 Long Island Avenue, Holtsville, NY 11742 | 2007-02-19 |
| 1245374560 | Maryhaven Center of Hope Inc. | Intermediate Care Facility, Mentally Retarded | 226 Eastport Manor Road, Manorville, NY 11949 | 2007-02-19 |
| 1215120399 | Maryhaven Center of Hope Inc. | Clinic/Center | 127 W Main St, Riverhead, NY 11901-2801 | 2007-08-22 |
| Street Address |
450 MYRTLE AVENUE HOUSE 1 |
| City | PORT JEFFERSON |
| State | NY |
| Zip Code | 11777 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952446569 | Maryhaven Center of Hope Inc. | Intermediate Care Facility, Mentally Retarded | 450 Myrtle Avenue, House B, Port Jefferson, NY 11777 | 2007-02-21 |
| 1487799094 | Maryhaven Center of Hope Inc. | Intermediate Care Facility, Mentally Retarded | 450 Myrtle Avenue, House C, Port Jefferson, NY 11777 | 2007-02-21 |
| 1568507911 | Maryhaven Center of Hope Inc. | Intermediate Care Facility, Mentally Retarded | 450 Myrtle Avenue, House A, Port Jefferson, NY 11777 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568088615 | Aqsa Ashraf | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mather Hospital Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-24 |
| 1366068975 | Manal Ahmad | Student in an Organized Health Care Education/Training Program | 75 N County Rd, Level 2 Cmo Suite, Internal Medicine Re, Mather Hospital, Port Jefferson, NY 11777 | 2020-06-19 |
| 1639794555 | Umair Ahmad Ansari | Student in an Organized Health Care Education/Training Program | 75 N Country Road Mother Hospital, Internal Medicine Re, Level 2 - Cmd Suite, Port Jefferson, NY 11777 | 2020-06-16 |
| 1578188132 | Manasi Sule | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Mather Hospital, Internal Medicine Res, Port Jefferson, NY 11777 | 2020-06-10 |
| 1508480716 | Imona Subedi | Student in an Organized Health Care Education/Training Program | 75 N Country Road, Level 2 - Cmo Suite, Mather Hospital Internal Medicine Residency Program, Port Jefferson, NY 11777 | 2020-06-03 |
| 1184252108 | Romana Imtiaz Syed | Student in an Organized Health Care Education/Training Program | Liza M Dominioni,mather Hospital,internal Medicine, Residency Program,level 2-cmo Suite,75 N Country Rd, Port Jefferson, NY 11777 | 2020-03-27 |
| 1649807348 | Mustafa Mohammed Abdulsada | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Ny, Level 2 - Cmo Suite, Port Jefferson, NY 11777 | 2020-03-24 |
| 1184264764 | Girma Moges Gamme | Surgery | 625 Belle Terre Rd, Suite 203 Mather Hospital, Port Jefferson, NY 11777 | 2020-01-10 |
| 1811554637 | Kausar Ali | Nurse Practitioner | 408 Thompson Street, Port Jefferson, NY 11777 | 2019-05-28 |
| 1073097531 | Ministry for Hope, Inc. Montfort Therapeutic Residence | Residential Treatment Facility, Physical Disabilities | 100 Stonyhill Road, Port Jefferson, NY 11777 | 2018-09-20 |
| Find all providers in zip 11777 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (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. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952446569 | Maryhaven Center of Hope Inc. | Intermediate Care Facility, Mentally Retarded | 450 Myrtle Avenue, House B, Port Jefferson, NY 11777 | 2007-02-21 |
| 1487799094 | Maryhaven Center of Hope Inc. | Intermediate Care Facility, Mentally Retarded | 450 Myrtle Avenue, House C, Port Jefferson, NY 11777 | 2007-02-21 |
| 1568507911 | Maryhaven Center of Hope Inc. | Intermediate Care Facility, Mentally Retarded | 450 Myrtle Avenue, House A, Port Jefferson, NY 11777 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336762665 | Schuyler County Chapter, Nysarc, Inc. | Intermediate Care Facility, Mentally Retarded | 260 W 8th St, Elmira Heights, NY 14903-1502 | 2020-05-21 |
| 1518580851 | Schuyler County Chapter, Nysarc, Inc. | Intermediate Care Facility, Mentally Retarded | 525 Liberty St, Elmira, NY 14904-1517 | 2020-05-21 |
| 1386276541 | United Cerebral Palsy of Nyc Inc | Intermediate Care Facility, Mentally Retarded | 1841-1845 Lacombe Ave, Bronx, NY 10472 | 2020-02-06 |
| 1003447012 | State of New York | Intermediate Care Facility, Mentally Retarded | 8045 Winchester Blvd Bldg 08, Queens Village, NY 11427-2194 | 2020-01-29 |
| 1427696061 | Elderberry Icf | Intermediate Care Facility, Mentally Retarded | 15 Poem Place, Monticello, NY 12701 | 2019-12-13 |
| 1538666052 | Upstate Cerebral Palsy, Inc. | Intermediate Care Facility, Mentally Retarded | 95 Seymour Lane, Westmoreland, NY 13490 | 2018-04-11 |
| 1457857716 | Nysarc, Inc. Cattaraugus-niagara County Chapter | Intermediate Care Facility, Mentally Retarded | 6821 Saunders Settlement Rd, Sanborn, NY 14132-9440 | 2018-04-04 |
| 1750804951 | Iri: Innovative Resources for Independence | Intermediate Care Facility, Mentally Retarded | 922 Rainbow Commons Ct, Melville, NY 11747 | 2017-07-19 |
| 1962959403 | Linda Burgess | Intermediate Care Facility, Mentally Retarded | 35 E 8th Ave, Gloversville, NY 12078-2229 | 2016-09-01 |
| 1154774727 | Birch Family Services, Inc. | Intermediate Care Facility, Mentally Retarded | 525 W 149th St, New York, NY 10031-3402 | 2016-07-19 |
| Find all providers with the same taxonomy | ||||
| City | PORT JEFFERSON |
| Zip Code | 11777 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.