NPIMap

Organization Active NPI

Long Island Ddso

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Commack, NY
National Provider Identifier
1366635732
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
LONG ISLAND DDSO
Practice address
45 Mall Dr
Suite 1
Commack, NY 11725-5700
Phone
(631) 493-1747
NPI assigned
Aug 20, 2007
Last updated
Aug 20, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Richard Rice
Title
Chief Psychologist
Phone
(631) 493-1747

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NY Primary

Addresses

Primary practice location

45 Mall Dr
Suite 1
Commack, NY 11725-5700

Mailing address

45 Mall Dr
Suite 1
Commack, NY 11725-5700

National Provider Directory

National Provider Directory
Tax ID family
Wilton Devel Ctr Rev M269 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

45 Mall Dr
Ste 1
Commack, NY 11725
Phone (631) 493-1747

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187568000000",
    "number": "1366635732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 MALL DR",
            "address_2": "SUITE 1",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117255700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MALL DR",
            "address_2": "SUITE 1",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117255700",
            "telephone_number": "631-493-1747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND DDSO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-20",
        "last_updated": "2007-08-20",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CHIEF PSYCHOLOGIST",
        "authorized_official_telephone_number": "631-493-1747",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.