# RISING TIDE HABILITATION SERVICES INC

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

## Provider details

- **NPI number:** 1639048804
- **Authorized official:** MARK MURRAY (DIRECTOR)
- **Authorized official phone:** (631) 948-4335

## Contact information

- **Practice address:** 496 SMITHTOWN BYP, SMITHTOWN, NY 11787-5005
- **Practice address phone:** (631) 909-3863
- **Mailing address:** 496 SMITHTOWN BYP, SMITHTOWN, NY 11787-5005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/04/2025
- **Last updated:** 11/04/2025