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Organization
DEVELOPMENTAL DISABILITIES INSTITUTE
Active
Organization
DEVELOPMENTAL DISABILITIES INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SOPHIA SAMUELS (CFO)
(631) 366-2960
Entity
Organization
Contact information
Practice address
90 AIRPARK DR., RONKONKOMA, NY 11779-7360
(631) 366-5876
Mailing address
99 HOLLYWOOD DRIVE, SMITHTOWN, NY 11787-3135
(631) 366-5876
(631) 366-5893
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NULL
252Y00000X
Early Intervention Provider Agency
Primary
580801997261
NY
Other
Enumeration date
01/10/2012
Last updated
08/16/2016
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