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Organization
DEVELOPMENTAL DISIABILITIES INSTITUTE
Active
Organization
DEVELOPMENTAL DISIABILITIES INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SOPHIA SAMUEL (A/R MANAGER)
(631) 366-2960
Entity
Organization
Contact information
Practice address
73 WADING RIVER HOLLOW RD, RIDGE, NY 11961-2315
(631) 366-5876
(631) 366-5893
Mailing address
99 HOLLYWOOD DR, SMITHTOWN, NY 11787-3135
(631) 366-2960
(631) 366-5893
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
04/23/2008
Last updated
08/14/2015
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