Mako Residence

NPI #1164540522 in Southold, New York

Provider Information

NPI Number: 1164540522
Entity Type: Organization
Organization Name: Mako Residence
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Mar 26, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 380 EDS RD
City: Southold
State: New York
ZIP Code: 11971-3716
Phone: (631) 665-3434

Authorized Official

Name: EDWIN M KENNEDY
Title: CFO
Phone: (516) 733-7000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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