Maggorie Shores Home LLC

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

Legal business name

MAGGORIE SHORES HOME LLC

Practice address

5566 Martin Luther King St S
St Petersburg, FL 33705-5139

Phone

(727) 434-1828

NPI assigned

Apr 6, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Todd E Bridges

Title

Owner

Phone

(727) 434-1828

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kori Monroe

  • Behavior Technician
  • St Petersburg, FL
  • NPI 1164954889
  NPD (past)

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1770016701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15421",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337335421",
            "telephone_number": "727-434-1828",
            "fax_number": "727-499-7943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5566 MARTIN LUTHER KING ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337055139",
            "telephone_number": "727-434-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGGORIE SHORES HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-06",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "BRIDGES",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-434-1828",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Madden
• Marianne Elizabeth Madrigal
• Wendy Maeder, BSW
• Maederer Counseling LLC
• Samantha Marlowe Maederer, LMHC
• Mary Magnant, M.S., CCC-SLP
• Madison Magnus, MS LMHC
• Elizabeth Magro, PSYD
• Matthew Allen Magruder
• Muniza Mobin Maha

• Assisted Living Facility (Behavioral Disturbances) in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Assisted Living Facility (Behavioral Disturbances) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.