NPIMap

Organization Active NPI

Maryhaven Center of Hope Inc.

  • Community/Behavioral Health Agency
  • Wantagh, NY
National Provider Identifier
1003146119
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
6825011 Issued in NY
Legal business name
MARYHAVEN CENTER OF HOPE INC.
Practice address
2957 Burns Avenue
Wantagh, NY 11793
Phone
(516) 783-3410
Fax
(516) 826-7688
NPI assigned
Jan 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Laura Pepper
Title
Director of Finance
Phone
(631) 474-4120

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 6825011 NY Primary

Addresses

Primary practice location

2957 Burns Avenue
Wantagh, NY 11793

Mailing address

51 Terryville Road
Port Jefferson Station, NY 11776
Phone (631) 474-4120

National Provider Directory

National Provider Directory
Tax ID family
Maryhaven Center of Hope Inc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

51 Terryville Rd
Port Jefferson Station, NY 11776
Phone (631) 474-4100

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430352000000",
    "number": "1003146119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 TERRYVILLE ROAD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "11776",
            "telephone_number": "631-474-4120",
            "fax_number": "631-474-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2957 BURNS AVENUE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "11793",
            "telephone_number": "516-783-3410",
            "fax_number": "516-826-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYHAVEN CENTER OF HOPE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-12",
        "last_updated": "2015-04-30",
        "status": "A",
        "authorized_official_last_name": "PEPPER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "631-474-4120"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "6825011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.