Maryhaven Center of Hope,Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

171212059 Issued in NY

Legal business name

MARYHAVEN CENTER OF HOPE,INC

Practice address

150 Buffalo Avenue
Freeport, NY 11520

Phone

(516) 546-7070

Fax

(516) 546-7075

NPI assigned

Feb 22, 2017

Organization subpart

No

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

Authorized official

Name

Lewis Grossman

Title

President/Ceo

Phone

(631) 474-4120

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487721600000",
    "number": "1477092575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 TERRYVILLE ROAD",
            "city": "PT. JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761331",
            "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": "150 BUFFALO AVENUE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "11520",
            "telephone_number": "516-546-7070",
            "fax_number": "516-546-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYHAVEN CENTER OF HOPE,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-22",
        "last_updated": "2017-02-22",
        "status": "A",
        "authorized_official_last_name": "GROSSMAN",
        "authorized_official_first_name": "LEWIS",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "631-474-4120"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NY",
            "license": "171212059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Martinez
• Ana Iris Martinez
• Francisco Antonio Martinez, MD
• Karen Stephanie Martinez, OTD, OTR/L
• Rachel Beth Martz Klein
• Michelle Masseus-Patterson
• John Francis Masters, DDS
• Mary Patricia Mathews
• Nicole Mattis-Catlin
• Edward Maurer, D.D.S.

• Substance Abuse Rehabilitation Facility in Freeport, NY
• Providers in Freeport, NY by specialty
• Substance Abuse Rehabilitation Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.