Organization
MAKO RESIDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN M KENNEDY (CFO)
(516) 733-7000
Entity
Organization
Contact information
Practice address
380 EDS RD, SOUTHOLD, NY 11971-3716
(631) 665-3434
Mailing address
380 EDS RD, SOUTHOLD, NY 11971-3716
(631) 665-3434
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
6186446
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02245898
—
NY
01
—
6186446
OPERATING CERTIFICATE
NY
Enumeration date
03/26/2007
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us