FIVE STAR MORNINGSIDE CHARLOTTESVILLE LLC NPI 1881633105

NPI Information

  • NPI: 1881633105
  • Provider Name: FIVE STAR MORNINGSIDE CHARLOTTESVILLE LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: MORNINGSIDE OF CHARLOTTESVILLE
  • CLIA Number: 49D2169573
  • Address: 491 CRESTWOOD DR
    CHARLOTTESVILLE, VA
    ZIP 22903
  • Phone: (434) 971-8889

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NPI Details

FIVE STAR MORNINGSIDE CHARLOTTESVILLE LLC is an assisted living facility in Charlottesville, VA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. FIVE STAR MORNINGSIDE CHARLOTTESVILLE LLC NPI is 1881633105. The provider is registered as an organization entity type.
The provider Is Doing Business As Morningside Of Charlottesville.

The provider's business location address is:

491 CRESTWOOD DR
CHARLOTTESVILLE, VA
ZIP 22903-869
Phone: (434) 971-8889
Fax: (434) 971-7889

The provider's authorized official is Bruce J Mackey .
The authorized official title is President & Chief Executive Officer and has the following contact phone number (617) 796-8214.

The CLIA number assigned to this NPI record is 49D2169573 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/5/2006 and was last updated on 6/27/2016.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityVLO-05-125VIRGINIAYes

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This page was last updated on: 3/30/2025

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