Vitality Star Resort Alf LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

VITALITY STAR RESORT ALF LLC

Practice address

591 SW Bradshaw Cir
Port St Lucie, FL 34953-5539

Phone

(772) 207-7947

NPI assigned

Oct 16, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Christella Dorval

Title

Administrator

Phone

(772) 207-7947

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vitality Star Resort Doing business as

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539648000000",
    "number": "1760958847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11380 SW HILLCREST CIR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872704",
            "telephone_number": "772-539-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 SW BRADSHAW CIR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349535539",
            "telephone_number": "772-207-7947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY STAR RESORT ALF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-10-16",
        "status": "A",
        "authorized_official_last_name": "DORVAL",
        "authorized_official_first_name": "CHRISTELLA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "772-207-7947",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023404800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vitality Star Resort",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victoria J Vislocky, DC
• Vital Health Center LLC
• Vital Home Care LLC
• Vitality Resort Alf LLC
• Vitality Spring Resort Alf LLC
• Vivas Counseling Services, LLC
• Sarah A. Vogler, M.D.
• Chantal Volcy
• Dieunade Volmy
• Louise Lorraine Voltaire, APRN

• Assisted Living Facility (Mental Illness) in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Assisted Living Facility (Mental Illness) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.