# DEVELOPMENTAL DISABILITIES INSTITUTE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215207162
- **Authorized official:** MRS. SOPHIA SAMUELS (CFO)
- **Authorized official phone:** (631) 366-2960

## Contact information

- **Practice address:** 90 AIRPARK DR., RONKONKOMA, NY 11779-7360
- **Practice address phone:** (631) 366-5876
- **Mailing address:** 99 HOLLYWOOD DRIVE, SMITHTOWN, NY 11787-3135
- **Mailing address phone:** (631) 366-5876
- **Mailing address fax:** (631) 366-5893

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | — |
| 252Y00000X | Early Intervention Provider Agency | 580801997261 | NY | Yes |

## Other

- **Enumeration date:** 01/10/2012
- **Last updated:** 08/16/2016