Organization Active NPI

Vitality Star Resort Alf LLC

Doing business as Vitality Star Resort

  • Assisted Living Facility (Mental Illness)
  • Port St Lucie, FL
National Provider Identifier
1760958847
Registry record updated Oct 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
Legal business name
VITALITY STAR RESORT ALF LLC
Doing business as
Vitality Star Resort
Practice address
591 SW Bradshaw Cir
Port St Lucie, FL 34953-5539
Phone
(772) 207-7947
NPI assigned
Oct 16, 2018
Last updated
Oct 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2018

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

Authorized official

Name
Mrs. Christella DorvalNPI 1770988180
Title
Administrator
Phone
(772) 207-7947

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X Primary

Addresses

Primary practice location

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

Mailing address

11380 SW Hillcrest Cir
Port St Lucie, FL 34987-2704
Phone (772) 539-0405

Other names 1

  • Vitality Star Resort Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vitality Star Resort",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

  • 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.