Organization
SIENA RESIDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN M KENNEDY (CFO)
(516) 733-7000
Entity
Organization
Contact information
Practice address
12 MECHANICSVILLE RD, BAY SHORE, NY 11706-7370
(631) 968-8007
Mailing address
12 MECHANICSVILLE RD, BAY SHORE, NY 11706-7370
(631) 968-8007
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01303497
—
NY
Enumeration date
03/23/2007
Last updated
08/22/2020
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