NPIMap

Organization Active NPI

Aid to the Developmentally Disabled, Inc

Doing business as Rise Life Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Riverhead, NY
National Provider Identifier
1912575762
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
AID TO THE DEVELOPMENTALLY DISABLED, INC
Doing business as
Rise Life Services
Practice address
901 E Main St Ste 500
Riverhead, NY 11901-2680
Phone
(631) 727-6220
NPI assigned
Jun 16, 2021
Last updated
Jan 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Authorized official

Name
Holly Gurnick
Title
Cfo
Phone
(631) 727-6220

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

901 E Main St Ste 500
Riverhead, NY 11901-2680

Mailing address

901 E Main St Ste 508
Riverhead, NY 11901-2680
Phone (631) 727-6220

Other names 1

  • Rise Life Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211216002901 NY Part B Supplier - Clinic/Group Practice 1658762182 Receives reassigned benefits from 11 practitioners
Practice locations: Riverhead, NY

National Provider Directory

National Provider Directory
Tax ID family
Add Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

901 E Main St
Ste 500
Riverhead, NY 11901
Phone (631) 727-6220

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769644800000",
    "number": "1912575762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E MAIN ST STE 508",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012680",
            "telephone_number": "631-727-6220",
            "fax_number": "631-727-6553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E MAIN ST STE 500",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012680",
            "telephone_number": "631-727-6220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AID TO THE DEVELOPMENTALLY DISABLED, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-16",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A",
        "authorized_official_last_name": "GURNICK",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "631-727-6220"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rise Life Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rise Life Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.