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MARYHAVEN CENTER OF HOPEINC NPI 1477092575


NPI Information

NPI: 1477092575
Provider Name: MARYHAVEN CENTER OF HOPE,INC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 33D2250442

Address:
150 BUFFALO AVENUE
FREEPORT, NY
ZIP 11520
Phone: (516) 546-7070
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MARYHAVEN CENTER OF HOPE,INC is a substance abuse rehabilitation facility in Freeport, NY. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. MARYHAVEN CENTER OF HOPE,INC NPI is 1477092575. The provider is registered as an organization entity type.

The provider's business location address is:

150 BUFFALO AVENUE
FREEPORT, NY
ZIP 11520
Phone: (516) 546-7070
Fax: (516) 546-7075

The provider's authorized official is Lewis Grossman .
The authorized official title is President/ceo and has the following contact phone number (631) 474-4120.

The CLIA number assigned to this NPI record is 33D2250442 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/22/2017 and was last updated on 2/22/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1324500000XSubstance Abuse Rehabilitation Facility171212059NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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