MEDICARE: OPEN ARMS INDEPENDENT LIVING FACILITY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	302R00000X	Health Maintenance Organization
2	310400000X	Assisted Living Facility
3	385H00000X	Respite Care
4	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1104504158
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN ARMS INDEPENDENT LIVING FACILITY LLC

Provider Business Mailing Address
First Line	:	2434 HEALY DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-3108
Country	:	US
Telephone Number	:	407-866-5644
Fax Number	:	407-730-5366

Provider Business Practice Location Address
First Line	:	2434 HEALY DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-3108
Country	:	US
Telephone Number	:	407-420-8716
Fax Number	:	407-286-5470

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	RENEE R JORDAN
Credential	:
Telephone Number	:	407-866-5644

Provider Enumeration Date	:	07/10/2023
Last Update Date	:	11/06/2025

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