Majestic Blue Care LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

MAJESTIC BLUE CARE LLC

Practice address

163 NW Doreen St
Port Saint Lucie, FL 34983-1533

Phone

(857) 222-0249

NPI assigned

Nov 7, 2024

Last updated

Nov 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kerry-Ann Ellington-RobinsonNPI 1205650223

Title

Manager

Phone

(857) 222-0249

Specialties & licenses 1

Addresses

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.

• Kerry Ann Ellington Robinson

  • Developmentally Disabled Services Day Training Agency
  • Port Saint Lucie, FL
  • NPI 1205650223
  NPD Authorized official

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

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1912721879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 NW DOREEN ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349831533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 NW DOREEN ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349831533",
            "telephone_number": "857-222-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAJESTIC BLUE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "ELLINGTON-ROBINSON",
        "authorized_official_first_name": "KERRY-ANN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "857-222-0249"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Terryann Mahabir, RN
• Mark Steven Maier, D.C.
• Ivania Nicole Mairena, RBT
• Makhni Cardiology and Medical Associates
• Marian Malmberg, PTA
• Kelly Maloch, D.O.
• Laraine Ann Malone, PTA
• Bernard Habaluyas Mamuyac, LMT

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.