Provider Demographics
NPI:1609033109
Name:MORNINGSTAR OF JUPITER, INC. 1 & 2
Entity Type:Organization
Organization Name:MORNINGSTAR OF JUPITER, INC. 1 & 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:CASSANO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:561-512-4088
Mailing Address - Street 1:101 WINGATE DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7617
Mailing Address - Country:US
Mailing Address - Phone:561-746-8806
Mailing Address - Fax:561-746-8806
Practice Address - Street 1:101 WINGATE DR
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7617
Practice Address - Country:US
Practice Address - Phone:561-746-8806
Practice Address - Fax:561-746-8806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10470310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility