Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Glen Haven Residential Healthcare Fac Inc

Organization Skilled Nursing Facility · NPI 1396742938

Glen Haven Residential Healthcare Fac Inc is a Skilled Nursing Facility in Port Jefferson, New York. Licensed in New York. Registered with an NPI since 2005.

Licensed in
NY
In the registry since
2005
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

150 Dark Hollow Rd
Port Jefferson, NY 11777-2048
Phone: (631) 473-5400
Fax: (631) 474-5362
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Skilled Nursing Facility (primary) Taxonomy 314000000X · Licence 5149303N (NY)

Record details

NPI number1396742938
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sanjay Ahuja — Vice President/Secretary · (631) 473-5400
Other names Port Jefferson Healthcare Facility Inc
NPI enumeratedJune 28, 2005
Last updated in NPPESJuly 9, 2015
Mailing address150 Dark Hollow Rd, Port Jefferson, NY 11777-2048

Other providers in Port Jefferson