Active NPI
Belle Vista Bluffs, Inc.
- Assisted Living Facility
- Largo, FL
National Provider Identifier
1730432980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- AL7888
- Legal business name
- BELLE VISTA BLUFFS, INC.
- Practice address
- 1138 Rosemary Dr
Largo, FL 33770-4219 - Phone
- (727) 587-0887
- Fax
- (727) 588-2397
- NPI assigned
- Oct 24, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Beverly C. Mackin
- Title
- Administrator
- Phone
- (727) 587-0887
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | AL7888 | FL | Primary |
| Assisted Living Facility | 310400000X | AL7261 | FL |
Addresses
Primary practice location
1138 Rosemary Dr
Largo, FL 33770-4219
Mailing address
1138 Rosemary Dr
Largo, FL 33770-4219
Phone (727) 587-0887
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 674094401 | Medicaid | FL | |
| 674094496 | Medicaid | FL | |
| 674094403 | Medicaid | FL |
National Provider Directory
National Provider DirectoryLocations
1138 Rosemary Dr
Largo, FL 33770
Phone (727) 587-0887
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351036800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1405900800000",
"number": "1730432980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1138 ROSEMARY DR",
"city": "LARGO",
"state": "FL",
"postal_code": "337704219",
"telephone_number": "727-587-0887",
"fax_number": "727-588-2397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1138 ROSEMARY DR",
"city": "LARGO",
"state": "FL",
"postal_code": "337704219",
"telephone_number": "727-587-0887",
"fax_number": "727-588-2397"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BELLE VISTA BLUFFS, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2012-10-24",
"last_updated": "2014-07-21",
"status": "A",
"authorized_official_last_name": "MACKIN",
"authorized_official_first_name": "BEVERLY",
"authorized_official_middle_name": "C.",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "727-587-0887"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "FL",
"license": "AL7888",
"primary": true
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "FL",
"license": "AL7261",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "674094401",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "674094496",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "674094403",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Largo, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.