OrganizationActive
Developmental Disabilities Institute, Inc
NPI 1700819299 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Smithtown, NY
Provider details
- NPI number
- 1700819299
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Ann-Marie Roza, Cfo(631) 366-2960
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
99 Hollywood Dr
Smithtown, NY 11787-3135
Phone: (631) 366-2900
Fax: (631) 366-2996
Approximate (ZIP-level) locationGet directions
Mailing address
99 Hollywood Dr
Smithtown, NY 11787-3135
Other names (DBA / former)
- Other name
- Ira
Registry dates
- Enumerated
- 2006-07-08
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.