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MAKO RESIDENCE
NPI 1164540522
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Southold, NY

Active since March 26, 2007
380 EDS RD, SOUTHOLD, NY 11971(631) 665-3434 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mako Residence NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAKO RESIDENCE (NPI 1164540522) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Southold, New York and active in the NPI registry since March 2007. The organization lists Edwin M Kennedy, Cfo, as its authorized official.

NPPES Registry Identity

NPI1164540522
Entity TypeOrganization
Primary Taxonomy320600000X
Legal Business NameMAKO RESIDENCE
Location Address380 EDS RDSouthold, NY 11971-3716
Mailing Address380 Eds RdSouthold, NY 11971-3716 · (631) 665-3434
Phone(631) 665-3434
Organization SubpartNo
Authorized OfficialEdwin M KennedyCfo · (516) 733-7000
Enumeration DateMarch 26, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1164540522 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320600000X
License✔ Licensed in NY · 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.
380 EDS RD, Southold, NY 11971
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Other Identifiers 2

Medicaid02245898NY
Other6186446NY · Operating Certificate

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mako Residence's NPI number?

The NPI number for Mako Residence is 1164540522. It was assigned to this organization in the NPPES registry on March 26, 2007.

Where is Mako Residence located?

Mako Residence is located at 380 Eds Rd, Southold, NY 11971. The listed phone number is (631) 665-3434.

What is Mako Residence's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

When was this NPI record last updated?

The NPPES record for Mako Residence was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.