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Organization
STATEN ISLAND DEVELOPMENTAL DISABILITIES SERVICES OFFICE
Active
Organization
STATEN ISLAND DEVELOPMENTAL DISABILITIES SERVICES OFFICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID E BOOTH PH.D (DIRECTOR)
(718) 983-5321
Entity
Organization
Contact information
Practice address
1150 FOREST HILL RD, STATEN ISLAND, NY 10314-6316
(718) 983-5365
(718) 983-5462
Mailing address
1150 FOREST HILL RD, STATEN ISLAND, NY 10314-6316
(718) 983-5365
(718) 983-5462
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
006544
NY
Other
Enumeration date
06/07/2007
Last updated
03/07/2023
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