Starlight Assisted Lining at Deland

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

STARLIGHT ASSISTED LINING AT DELAND

Doing business as

Starlight ALF At Deland

Practice address

1180 Jackson Ranch Rd
Deland, FL 32724-7900

Phone

(386) 740-9117

Fax

(386) 624-6002

NPI assigned

Feb 20, 2023

Last updated

Feb 20, 2023By 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

Runell Fitzgerald Gordon

Title

Administrator

Phone

(720) 998-6303

Specialties & licenses 1

Addresses

Other names 1

• Starlight ALF At Deland Doing business as

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1578261541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 JACKSON RANCH RD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327247900",
            "telephone_number": "386-740-9117",
            "fax_number": "386-624-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 JACKSON RANCH RD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327247900",
            "telephone_number": "386-740-9117",
            "fax_number": "386-624-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARLIGHT ASSISTED LINING AT DELAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "RUNELL",
        "authorized_official_middle_name": "FITZGERALD",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "720-998-6303"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Starlight ALF At Deland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Deland, FL
• Providers in Deland, 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 Feb 20, 2023; 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.