Port Jefferson Healthcare Facility Inc

LBN: Glen Haven Residential Healthcare Fac. Inc
Port Jefferson Healthcare Facility Inc is an health care organization with primary practice located at 150 Dark Hollow Rd , Port Jefferson NY 11777-2048. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Glen Haven Residential Healthcare Fac. Inc can be contacted via phone (631) 473-5400, or through Ahuja, Sanjay via phone (631) 473-5400.

Contact Information

Primary practice address
150 Dark Hollow Rd Port Jefferson NY 11777-2048
Phone: (631) 473-5400
Fax: (631) 474-5362
Website:
Map and Directions
Authorized official contact:
Name: Ahuja, Sanjay
Phone: (631) 473-5400

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 5149303N New York

Profile Details

NPI number 1396742938
LBN Legal business name Glen Haven Residential Healthcare Fac. Inc
DBA Doing business as Port Jefferson Healthcare Facility Inc
Authorized official Ahuja, Sanjay
Entity Organization
Organization subpart 1 No
Enumeration date Jun 28th, 2005
Last updated Jul 9th, 2015 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396742938 NPPES
New York MEDICAID 01004640

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