WOODHAVEN ADULT HOME, LLC
NPI 1609998681
Assisted Living Facility in Port Jefferson Station, NY

Q: What is Woodhaven Adult Home, LLC's NPI number?

The NPI number for Woodhaven Adult Home, LLC is 1609998681. It was assigned to this organization in the NPPES registry on April 3, 2007.

Q: What is Woodhaven Adult Home, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since April 03, 2007

1350 ROUTE 112, PORT JEFFERSON STATION, NY 11776(631) 473-7100(631) 473-7118 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Woodhaven Adult Home, Llc NPPES

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

WOODHAVEN ADULT HOME, LLC (NPI 1609998681) is a healthcare organization registered as an assisted living facility in Port Jefferson Station, New York and active in the NPI registry since April 2007. The organization lists Kenneth E Gaul, Sole Member, as its authorized official.

NPPES Registry Identity

NPI1609998681

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameWOODHAVEN ADULT HOME, LLC

Location Address1350 ROUTE 112Port Jefferson Station, NY 11776-3078

Mailing Address1360 Route 112Port Jefferson Station, NY 11776-3078 · (631) 473-7100 · Fax (631) 473-7118

Phone(631) 473-7100

Fax(631) 473-7118

Organization SubpartNo

Authorized OfficialKenneth E GaulSole Member · (631) 473-7100

Enumeration DateApril 3, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1609998681 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in NY · 700-F-905

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

1350 ROUTE 112, Port Jefferson Station, NY 11776

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Other Identifiers 1

Medicaid02362614NY

Other Providers at the Same Location NPPES 3

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

HAVEN MEDICAL SERVICES, PLC

Internal Medicine

1350 ROUTE 112
PORT JEFFERSON STATION, NY 11776

Suffolk County (631) 473-3304

DR. CHRISTOPHER PAUL ANTIPAS PH.D.

Psychologist (Clinical)

1350 ROUTE 112
PORT JEFFERSON STATION, NY 11776

Suffolk County (631) 745-9005

PHYT, INC.

Physical Therapist

1350 ROUTE 112
PORT JEFFERSON STATION, NY 11776

Suffolk County (718) 256-6000

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 Woodhaven Adult Home, LLC's NPI number?

The NPI number for Woodhaven Adult Home, LLC is 1609998681. It was assigned to this organization in the NPPES registry on April 3, 2007.

Where is Woodhaven Adult Home, LLC located?

Woodhaven Adult Home, LLC is located at 1350 Route 112, Port Jefferson Station, NY 11776. The listed phone number is (631) 473-7100.

What is Woodhaven Adult Home, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Woodhaven Adult Home, LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.