VITALITY STAR RESORT ALF LLC (NPI# 1760958847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760958847 |
| Entity Type | Organization |
| Organization Name | VITALITY STAR RESORT ALF LLC |
| Practice Address |
591 Sw Bradshaw Cir Port St Lucie FL 34953-5539 |
| Mailing Address |
11380 Sw Hillcrest Cir Port St Lucie FL 34987-2704 |
| Practice Telephone | 7722077947 |
| Mailing Telephone | 7725390405 |
| Enumeration Date | 2018-10-16 |
| Last Update Date | 2018-10-16 |
| Authorized Official Name | MRS. CHRISTELLA DORVAL (ADMINISTRATOR) |
| Authorized Official Telephone | 7722077947 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 023404800 | 05 |
| Other Name | Type Code |
|---|---|
| Vitality Star Resort | Doing Business As Name - Organization |
| Street Address |
591 SW BRADSHAW CIR |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34953-5539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033733720 | Paul Desantis | Optometrist | 1805 Gatlin Blvd, Port St. Lucie, FL 34953 | 2020-05-29 |
| 1174165997 | D&r Homehealthcare LLC | Technician | 1210 Southwest Santiago Avenue, Port Saint Lucie, Fl, FL 34953 | 2019-10-14 |
| 1023677630 | Physical Therapy Wellness Group | Clinic/Center | 519 Sw Nagle Place, Port Saint Lucie, FL 34953 | 2019-06-07 |
| 1063993699 | Bloom Firm, LLC | Home Health | 1714 Sw Cycle St, Port Saint Lucie, FL 34953 | 2018-08-22 |
| 1386121333 | For His Glory Alf LLC. | Assisted Living Facility | 322 Sw South Quick Circle, Port St Lucie, FL 34953 | 2018-07-23 |
| 1730670555 | Susan May Thyme | Nurse Practitioner | 1762 Sw Choate St, Port Saint Lucie, FL 34953 | 2018-05-29 |
| 1164911301 | Viven Banks | Counselor | 3581 Sw Kromrey St, Port Saint Lucie, FL 34953 | 2018-05-03 |
| 1205323441 | Katherine Monroig | Behavior Technician | 4557 Se Babylon St, Port Saint Lucie, FL 34953 | 2018-04-13 |
| 1528567583 | Roger Rene Trudel | Nurse Practitioner | 3686 Sw Carmody Street, Port St Lucie, FL 34953 | 2018-02-06 |
| 1801315502 | Metushela Nicolas | Adult Companion | 1112 Jennifer Ter, Port Saint Lucie, FL 34953 | 2017-09-13 |
| Find all providers in zip 34953 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245755966 | Vedadevi LLC | Assisted Living Facility | 1538 Se Faculty Ct, Port St Lucie, FL 34952-7603 | 2017-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952910200 | Darielle Shanette Berrian | Assisted Living Facility | 1548 Georgetown Dr, Lakeland, FL 33811 | 2020-07-23 |
| 1003434028 | Carolyn Clanton Alf LLC | Assisted Living Facility | 1146 Hamilton Ave, Jennings, FL 32053-2253 | 2020-07-07 |
| 1356964555 | Cordoba Alf LLC | Assisted Living Facility | 1135 Sw 100th Ct, Miami, FL 33174-2848 | 2020-05-21 |
| 1205461563 | Alegria Alf LLC | Assisted Living Facility | 1150 Sw 103rd Ct, Miami, FL 33174-2759 | 2020-03-06 |
| 1134764368 | Aum Haven LLC | Assisted Living Facility | 2763 Carmel Ct, Kissimmee, FL 34746-3268 | 2019-11-12 |
| 1275180515 | 1161 Cambridge LLC | Assisted Living Facility | 1161 W 2nd St, Riviera Beach, FL 33404-7627 | 2019-08-21 |
| 1386291623 | Cambridge 13 LLC | Assisted Living Facility | 1560 W 13th St, Riviera Beach, FL 33404-6521 | 2019-08-21 |
| 1851948418 | 3411 Ave Cambridge LLC | Assisted Living Facility | 3411 Avenue H E, Riviera Beach, FL 33404-2101 | 2019-08-19 |
| 1326694308 | W 2nd Cambridge LLC | Assisted Living Facility | 570 W 2nd St, Riviera Beach, FL 33404-7616 | 2019-08-14 |
| 1154976512 | Quality Health Care of Florida.llc | Assisted Living Facility | 1250 Nw 122nd Ave, Plantation, FL 33323-2420 | 2019-08-02 |
| Find all providers with the same taxonomy | ||||
| City | PORT ST LUCIE |
| Zip Code | 34953 |
Please comment or provide details below to improve the information on VITALITY STAR RESORT ALF LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.