Healthcare Provider Details

I. General information

NPI: 1174167589
Provider Name (Legal Business Name): RYHANS CENTER OF HOPE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2019
Last Update Date: 10/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

387 E MAIN ST STE 106
BAY SHORE NY
11706-8413
US

IV. Provider business mailing address

PO BOX 1337
BAY SHORE NY
11706-0538
US

V. Phone/Fax

Practice location:
  • Phone: 631-647-8770
  • Fax: 631-647-8772
Mailing address:
  • Phone: 631-647-8770
  • Fax: 631-647-8772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHELE BRYANT
Title or Position: DIRECTOR
Credential:
Phone: 631-647-8770