GV St. Pete, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12561 Issued in FL

Legal business name

GV ST. PETE, LLC

Doing business as

Grand Villa of St. Petersburg

Practice address

13770 58TH St N
Suite 312
Clearwater, FL 33760-3759

Phone

(727) 726-3980

NPI assigned

Oct 2, 2014

Last updated

Oct 2, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Bonnie Williamson

Title

Operations Manager

Phone

(727) 726-3980

Specialties & licenses 1

Addresses

Other names 1

• Grand Villa of St. Petersburg Doing business as

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

{
    "created_epoch": "1412208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412208000000",
    "number": "1457754558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 34TH ST S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337113800",
            "telephone_number": "727-350-5830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13770 58TH ST N",
            "address_2": "SUITE 312",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337603759",
            "telephone_number": "727-726-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GV ST. PETE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-02",
        "last_updated": "2014-10-02",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "727-726-3980",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Villa of St. Petersburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Joseph E Haas, M.D.
• Mitch Haas, DPT

• Assisted Living Facility in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.