Provider Demographics
NPI:1558781476
Name:DEVELOPMENTAL DISABILITIES SUPPORT SERVICES
Entity Type:Organization
Organization Name:DEVELOPMENTAL DISABILITIES SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:OPARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-414-0536
Mailing Address - Street 1:5 STAMY DR STE 2
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-2717
Mailing Address - Country:US
Mailing Address - Phone:609-469-1958
Mailing Address - Fax:
Practice Address - Street 1:5 STAMY DR STE 2
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-2717
Practice Address - Country:US
Practice Address - Phone:609-414-0536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-17
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care