Starline Group Home

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

STARLINE GROUP HOME

Practice address

820 SW del Rio Blvd FL 34953
Port St Lucie, FL 34953-1979

Phone

(177) 222-4974

NPI assigned

Jan 31, 2022

Organization subpart

No

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

Authorized official

Name

Agnes Joan Leslie

Title

Director

Phone

(772) 224-9746

Specialties & licenses 1

Addresses

Other names 1

• Starline Group Home Doing business as

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1417600313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 SW DEL RIO BLVD FL 34953",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349531979",
            "telephone_number": "177-222-4974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 SW DEL RIO BLVD FL 34953",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349531979",
            "telephone_number": "177-222-4974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARLINE GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A",
        "authorized_official_last_name": "LESLIE",
        "authorized_official_first_name": "AGNES",
        "authorized_official_middle_name": "JOAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "772-224-9746"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Starline Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Developmentally Disabled Services Day Training Agency in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Developmentally Disabled Services Day Training Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.