MARYHAVEN CENTER OF HOPE INC.
NPI 1487799094
Intermediate Care Facility, Intellectual Disabilities in Port Jefferson, NY

NPI Status: Active since February 21, 2007

Contact Information

450 MYRTLE AVENUE
HOUSE C
PORT JEFFERSON, NY
ZIP 11777
Phone: (631) 474-3400
Fax: (631) 474-4181

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About MARYHAVEN CENTER OF HOPE INC.

This page provides the complete NPI Profile along with additional information for Maryhaven Center Of Hope Inc., a provider established in Port Jefferson, New York operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1487799094 assigned on February 2007. The practitioner's primary taxonomy code is 315P00000X with license number 6639495 (NY). The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Laura Pepper (Director Of Finance)

NPI
1487799094
Provider Name
MARYHAVEN CENTER OF HOPE INC.
Entity Type
Organization
Location Address
450 MYRTLE AVENUE HOUSE C PORT JEFFERSON, NY 11777
Location Phone
(631) 474-3400
Location Fax
(631) 474-4181
Mailing Address
51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776
Mailing Phone
(631) 474-4120
Mailing Fax
(631) 474-4181
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-21-2007
Last Update Date
04-30-2015
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Intermediate Care Facility, Intellectual Disabilities

Taxonomy Code
315P00000X
Type
Nursing & Custodial Care Facilities
License No.
6639495
License State
NY
Taxonomy Description
An intermediate care facility providing services for individuals with intellectual disabilities.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

LAURA PEPPER

Authorized Official Title
DIRECTOR OF FINANCE
Authorized Official Phone
(531) 474-4120

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
01042048MEDICAID (05)NY 

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1487799094
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2416714918018
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 1 + 6 + 7 + 1 + 4 + 9 + 1 + 8 + 0 + 1 + 8 + 24 = 76
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 76 = 44

The NPI number 1487799094 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 3 providers are registered at the same or nearby location.

MARYHAVEN CENTER OF HOPE INC.

Intermediate Care Facility, Intellectual Disabilities

450 MYRTLE AVENUE
HOUSE 1
PORT JEFFERSON, NY
ZIP 11777

(631) 331-6186

MARYHAVEN CENTER OF HOPE INC.

Intermediate Care Facility, Intellectual Disabilities

450 MYRTLE AVENUE
HOUSE B
PORT JEFFERSON, NY
ZIP 11777

(631) 474-3400

MARYHAVEN CENTER OF HOPE INC.

Intermediate Care Facility, Intellectual Disabilities

450 MYRTLE AVENUE
HOUSE A
PORT JEFFERSON, NY
ZIP 11777

(631) 474-3400

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1487799094, enumerated as an "organization" on February 21, 2007.

The provider is located at 450 MYRTLE AVENUE HOUSE C PORT JEFFERSON, NY 11777 and the phone number is (631) 474-3400.

Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.