Organization Active NPI

Hse-Ahr St Petersburg TRS LLC

  • Assisted Living Facility
  • St Petersburg, FL
National Provider Identifier
1043940950
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
HSE-AHR ST PETERSBURG TRS LLC
Doing business as
AMERICAN HOUSE ST PETERSBURG
Practice address
1101 66TH Street N
St Petersburg, FL 33710
Phone
(727) 513-8830
Fax
(727) 683-9503
NPI assigned
Jun 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eugene Valentine
Title
Executive Director
Phone
(727) 336-9940

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

1101 66TH Street N
St Petersburg, FL 33710

Mailing address

1101 66TH Street North
St Petersburg, FL 33710
Phone (727) 513-8830

Other names 1

  • AMERICAN HOUSE ST PETERSBURG Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2241804American House St Petersburg1101 66TH St N, Saint Petersburg, FL 33710Certificate of waiverNov 1, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1043940950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 66TH STREET NORTH",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33710",
            "telephone_number": "727-513-8830",
            "fax_number": "727-683-9503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 66TH STREET N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33710",
            "telephone_number": "727-513-8830",
            "fax_number": "727-683-9503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HSE-AHR ST PETERSBURG TRS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "VALENTINE",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "727-336-9940"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMERICAN HOUSE ST PETERSBURG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.