Healthcare Provider Details

I. General information

NPI: 1982401451
Provider Name (Legal Business Name): EMMA HAVEN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 03/03/2025
Certification Date: 03/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E HUDSON ST
LONG BEACH NY
11561-2135
US

IV. Provider business mailing address

120 E HUDSON ST
LONG BEACH NY
11561-2135
US

V. Phone/Fax

Practice location:
  • Phone: 516-234-3303
  • Fax:
Mailing address:
  • Phone: 516-234-3303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: NATALIE MILLER
Title or Position: CO FOUNDER
Credential:
Phone: 516-234-3303