Organization
MARYHAVEN CENTER OF HOPE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA PEPPER (DIRECTOR OF FINANCE)
(631) 474-4120
Entity
Organization
Contact information
Practice address
64 N CORONA AVENUE, VALLEY STREAM, NY 11580
(516) 872-6103
(516) 872-6120
Mailing address
51 TERRYVILLE ROAD, PORT JEFFERSON STATION, NY 11776
(631) 474-4120
(631) 474-1312
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6825009
NY
Other
Enumeration date
01/13/2010
Last updated
05/01/2015
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