MEDICARE: RADIANT LIFE GROUP HOMES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	310400000X	Assisted Living Facility
2	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
3	251C00000X	Developmentally Disabled Services Day Training Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871460162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADIANT LIFE GROUP HOMES, LLC

Provider Business Mailing Address
First Line	:	2852 HICKORY CREEK DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-3066
Country	:	US
Telephone Number	:	352-386-6482
Fax Number	:

Provider Business Practice Location Address
First Line	:	2852 HICKORY CREEK DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-3066
Country	:	US
Telephone Number	:	352-386-6482
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER ; ADMINISTRATOR
Name	:	MS. VALERIE BELVU
Credential	:	COO AND TEAM LEADER
Telephone Number	:	352-386-6482

Provider Enumeration Date	:	10/21/2025
Last Update Date	:	10/21/2025

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