MARYHAVEN CENTER OF HOPE INC. (NPI# 1225172521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225172521 |
| Entity Type | Organization |
| Organization Name | MARYHAVEN CENTER OF HOPE INC. |
| Practice Address |
1385 N Ocean Avenue Medford NY 11763 |
| Mailing Address |
51 Terryville Road Port Jefferson Station NY 11776 |
| Practice Telephone | 6312896157 |
| Practice Fax Number | 6314752477 |
| Mailing Telephone | 6314744120 |
| Mailing Fax Number | 6314741312 |
| Enumeration Date | 2007-02-19 |
| 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 | 6639491 | NY | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01008171 | 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 |
| 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 |
| 1043354681 | Maryhaven Center of Hope Inc. | Intermediate Care Facility, Mentally Retarded | 450 Myrtle Avenue, House 1, Port Jefferson, NY 11777 | 2007-02-16 |
| 1215120399 | Maryhaven Center of Hope Inc. | Clinic/Center | 127 W Main St, Riverhead, NY 11901-2801 | 2007-08-22 |
| Street Address |
1385 N OCEAN AVENUE |
| City | MEDFORD |
| State | NY |
| Zip Code | 11763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316572027 | Rebecca Molino | Specialist | 9, 3251 Ny-112 #2, Medford, NY 11763 | 2020-03-03 |
| 1295203677 | Hajar Taman | Pharmacist | 2975 Horseblock Road, Medford, NY 11763 | 2018-11-05 |
| 1265917041 | Bay Taxi Inc | Taxi | 36/94 Horseblock Rd, Medford, NY 11763 | 2018-09-27 |
| 1184108383 | Bay Taxi Inc | Taxi | 36/94 Horsblock Road, Medford, NY 11763 | 2018-09-24 |
| 1215419650 | Megan Bell | Speech-Language Pathologist | 135 Buffalo Avenue, Medford, NY 11763 | 2018-09-01 |
| 1922592906 | Elizabeth L Oakley | Specialist | 1 Sprat St, Medford, NY 11763 | 2018-06-21 |
| 1609383389 | Federation of Organizations for The New York State Mentally Disabled | Clinic/Center | 3390 Route 112 Ste B, Medford, NY 11763 | 2018-01-04 |
| 1497109607 | Tabitha Aitken | Massage Therapist | 28 Masem Ct, Medford, NY 11763 | 2016-04-14 |
| 1518326685 | Betty Velez | Specialist | 21 Red Pine Rd, Medford, NY 11763 | 2016-02-18 |
| 1134527054 | Angelo L D'esposito | Social Worker | 77 Robinson Ave, Medford, NY 11763 | 2014-12-09 |
| Find all providers in zip 11763 | ||||
| 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 |
|---|---|---|---|---|
| 1962877126 | Voca Corporation of New Jersey | Intermediate Care Facility, Mentally Retarded | 1 Utah Trl, Medford, NJ 08055-8913 | 2015-12-14 |
| 1326213190 | Developmental Disiabilities Institute | Intermediate Care Facility, Mentally Retarded | 757 Old Medford Ave, Medford, NY 11763-3527 | 2008-04-23 |
| 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 | ||||
Please comment or provide details below to improve the information on MARYHAVEN CENTER OF HOPE INC..
| 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.