Organization
DEVELOPMENTAL DISABILITIES INSTITUTE, INC.
Active
Other names
Opti-Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
SOPHIA SAMUEL CPA (CFO)
(631) 366-2960
Entity
Organization
Contact information
Practice address
883 E MAIN ST, RIVERHEAD, NY 11901-2613
(631) 284-5500
(631) 369-7421
Mailing address
99 HOLLYWOOD DR, SMITHTOWN, NY 11787-3135
(631) 366-2900
(631) 366-2935
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01464520
—
NY
Enumeration date
05/19/2006
Last updated
06/24/2014
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