NPIMap

Organization Active NPI

Morningstar Assisted Living, LLC

Doing business as Baytree Lakeside

  • Assisted Living Facility
  • St Petersburg, FL
National Provider Identifier
1720329063
Registry record updated Dec 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
6773 Issued in FL
Legal business name
MORNINGSTAR ASSISTED LIVING, LLC
Doing business as
Baytree Lakeside
Practice address
6411 46TH Ave N
St Petersburg, FL 33709-3105
Phone
(727) 545-0623
Fax
(727) 544-2416
NPI assigned
Mar 12, 2013
Organization subpart
Yes
Parent organization
MORNINGSTAR ASSISTED LIVING, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2017

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

Authorized official

Name
Laura Goicu
Title
Owner
Phone
(360) 920-9598

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 6773 FL Primary

Addresses

Primary practice location

6411 46TH Ave N
St Petersburg, FL 33709-3105

Mailing address

17920 Gulf Blvd Apt 703
Redington Shores, FL 33708-1143
Phone (360) 920-9598

Other identifiers 1

IdentifierTypeStateIssuer
008294100MedicaidFL

Other names 1

  • Baytree Lakeside Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Morningstar Senior Living LLC4 organizations share this tax ID, including this one
Part of
Morningstar Senior Living LLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513555200000",
    "number": "1720329063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17920 GULF BLVD APT 703",
            "city": "REDINGTON SHORES",
            "state": "FL",
            "postal_code": "337081143",
            "telephone_number": "360-920-9598",
            "fax_number": "727-914-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 46TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337093105",
            "telephone_number": "727-545-0623",
            "fax_number": "727-544-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORNINGSTAR ASSISTED LIVING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MORNINGSTAR ASSISTED LIVING, LLC",
        "enumeration_date": "2013-03-12",
        "last_updated": "2017-12-18",
        "status": "A",
        "authorized_official_last_name": "GOICU",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-920-9598"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "6773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008294100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baytree Lakeside",
            "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 Dec 18, 2017; 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.