Provider Demographics
NPI:1689283178
Name:SUS - DEVELOPMENTAL DISABILITIES SERVICES, INC.
Entity Type:Organization
Organization Name:SUS - DEVELOPMENTAL DISABILITIES SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERLMUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-565-5887
Mailing Address - Street 1:463 7TH AVENUE
Mailing Address - Street 2:17TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-7595
Mailing Address - Country:US
Mailing Address - Phone:646-565-5896
Mailing Address - Fax:855-370-9384
Practice Address - Street 1:463 7TH AVENUE
Practice Address - Street 2:17TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-7595
Practice Address - Country:US
Practice Address - Phone:646-565-5896
Practice Address - Fax:855-370-9384
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SERVICES FOR THE UNDERSERVED INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities