PORT JEFFERSON HEALTHCARE FACILITY INC
NPI 1396742938
Skilled Nursing Facility in Port Jefferson, NY

Active since June 28, 2005
150 DARK HOLLOW RD, PORT JEFFERSON, NY 11777(631) 473-5400(631) 474-5362 Get Directions Write a Review

NPPES record last updated: July 9, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Port Jefferson Healthcare Facility Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PORT JEFFERSON HEALTHCARE FACILITY INC (NPI 1396742938) is a healthcare organization registered as a skilled nursing facility in Port Jefferson, New York and active in the NPI registry since June 2005. The organization lists Sanjay Ahuja, Vice President/secretary, as its authorized official.

NPPES Registry Identity

NPI1396742938
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameGLEN HAVEN RESIDENTIAL HEALTHCARE FAC. INC
Location Address150 DARK HOLLOW RDPort Jefferson, NY 11777-2048
Mailing Address150 Dark Hollow RdPort Jefferson, NY 11777-2048 · (631) 473-5400 · Fax (631) 474-5362
Fax(631) 474-5362
Organization SubpartNo
Authorized OfficialSanjay AhujaVice President/secretary · (631) 473-5400
Enumeration DateJune 28, 2005
Last NPPES UpdateJuly 9, 2015
NPI 1396742938 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in NY · 5149303N
Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

150 DARK HOLLOW RD, Port Jefferson, NY 11777

Other Names 1

Doing Business AsPort Jefferson Healthcare Facility Inc

Other Identifiers 2

Medicare ID-Type Unspecified335410NY · Killed Nursing Facility
Medicaid01004640NY

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Rehabilitation)
150 DARK HOLLOW RD
PORT JEFFERSON, NY 11777
Skilled Nursing Facility
150 DARK HOLLOW RD
PORT JEFFERSON, NY 11777
Registered Nurse (Infection Control)
150 DARK HOLLOW RD
PORT JEFFERSON, NY 11777
Speech-Language Pathologist
150 DARK HOLLOW RD
PORT JEFFERSON, NY 11777
Occupational Therapist
150 DARK HOLLOW RD
PORT JEFFERSON, NY 11777
Nurse Practitioner (Gerontology)
150 DARK HOLLOW RD
PORT JEFFERSON, NY 11777
Nurse Practitioner (Family)
150 DARK HOLLOW RD
PORT JEFFERSON, NY 11777

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glen Haven Residential Healthcare Fac. Inc's NPI number?

The NPI number for Glen Haven Residential Healthcare Fac. Inc is 1396742938. It was assigned to this organization in the NPPES registry on June 28, 2005. The provider is doing business as Port Jefferson Healthcare Facility Inc.

Where is Glen Haven Residential Healthcare Fac. Inc located?

Glen Haven Residential Healthcare Fac. Inc is located at 150 Dark Hollow Rd, Port Jefferson, NY 11777. The listed phone number is (631) 473-5400.

What is Glen Haven Residential Healthcare Fac. Inc's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

When was this NPI record last updated?

The NPPES record for Glen Haven Residential Healthcare Fac. Inc was last updated on July 9, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.