Mako Residence in Southold - Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Mako Residence - NPI 1164540522
Mako Residence is a Residential Treatment Facility, Intellectual And/or Developmental Disabilities in Southold, New York. Mako Residence practices all healthcare services and medical treatments related to Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The NPI Number for Mako Residence is 1164540522. The last update date is 2020-08-22.
Mako Residence's current location address is 380 Eds Rd, Southold, New York. You can contact this provider via phone number 6316653434. The mailing address for Mako Residence is 380 Eds Rd, Southold, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Mako Residence |
|---|---|
| Address | 380 Eds Rd, Southold, New York |
| Phone Number | 6316653434 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CFO |
|---|---|
| Authorized Official Name | Kennedy M Edwin |
| Telephone Number | 5167337000 |
NPI Number Detail
| NPI Number | 1164540522 |
|---|---|
| Provider Enumeration Date | 2007-03-26 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 380 Eds Rd |
|---|---|
| City | Southold |
| State | New York (NY) |
| Post Code | 119713716 |
| Phone Number | 6316653434 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
|---|---|
| Taxonomy | 320600000X |
| Licence No | 6186446 |
|
Definition: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2245898 | NY | -- | |
| 6186446 | NY | OPERATING CERTIFICATE |
Post Comment/ Review Below
What is the unique provider identifier assigned to Mako Residence?
The Mako Residence has been issued the NPI (National Provider Identifier) 1164540522 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Mako Residence's facilities are geographically located?
The facilities of Mako Residence are physically situated at the following location: 380 Eds Rd, Southold, NY, 119713716.
What is Mako Residence's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Mako Residence's specialized field of practice is Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the corresponding taxonomy code that categorizes this area of specialization is 320600000X.
On what date did the Mako Residence receive its 1164540522 assignment from the Centers for Medicare & Medicaid Services?
The Mako Residence was assigned its 1164540522 by the Centers for Medicare & Medicaid Services on 2007-03-26.
When was the information regarding Mako Residence, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Mako Residence, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2020-08-22.
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