| Maryhaven Center Of Hope Inc. | |
|
445 County Road 101 Yaphank NY 11980 | |
| (631) 924-5900 | |
| (631) 924-2464 |
| Full Name | Maryhaven Center Of Hope Inc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 445 County Road 101, Yaphank, New York |
| Authorized Official Name and Position | Laura Pepper (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 6314744120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryhaven Center Of Hope Inc. 51 Terryville Road Port Jefferson Station NY 11776 Ph: (631) 474-4120 | Maryhaven Center Of Hope Inc. 445 County Road 101 Yaphank NY 11980 Ph: (631) 924-5900 |
| NPI Number | 1417149386 |
|---|---|
| Provider Enumeration Date | 08/15/2007 |
| Last Update Date | 05/01/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417149386 | NPI | - | NPPES |
| 03012315 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 6825007A (New York) | Primary |