OrganizationActive
Long Island Ddso
NPI 1366635732 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Commack, NY
Provider details
- NPI number
- 1366635732
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Richard Rice, Chief Psychologist(631) 493-1747
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
45 Mall Dr
Suite 1
Commack, NY 11725-5700
Phone: (631) 493-1747
Approximate (ZIP-level) locationGet directions
Mailing address
45 Mall Dr
Commack, NY 11725-5700
Registry dates
- Enumerated
- 2007-08-20
- Last updated
- 2007-08-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.