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MAGGORIE SHORES HOME LLC NPI 1770016701


NPI Information

NPI: 1770016701
Provider Name: MAGGORIE SHORES HOME LLC
Classification: Assisted Living Facility - 3104A0630X
Entity Type: Organization

Specialization: Assisted Living, Behavioral Disturbances

Address:
5566 MARTIN LUTHER KING ST S
ST PETERSBURG, FL
ZIP 33705
Phone: (727) 434-1828
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MAGGORIE SHORES HOME LLC is an assisted living and behavioral disturbances assisted living facility in St Petersburg, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. MAGGORIE SHORES HOME LLC NPI is 1770016701. The provider is registered as an organization entity type.

The provider's business location address is:

5566 MARTIN LUTHER KING ST S
ST PETERSBURG, FL
ZIP 33705-139
Phone: (727) 434-1828

The provider's authorized official is Todd E Bridges .
The authorized official title is Owner and has the following contact phone number (727) 434-1828.

The enumeration date for this NPI number is 4/6/2017 and was last updated on 4/6/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311ZA0620XCustodial Care FacilityAdult Care HomeNo
23104A0630XAssisted Living FacilityAssisted Living, Behavioral DisturbancesYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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