Open Arms Med Waiver Provider, Inc

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

OPEN ARMS MED WAIVER PROVIDER, INC

Practice address

37640 Quail Ridge Cir
Leesburg, FL 34788-8117

Phone

(352) 551-3263

Fax

(352) 589-4442

NPI assigned

Jun 26, 2007

Last updated

May 15, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Antony M Schlissio

Title

Co-Owner

Phone

(352) 551-3263

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1871799890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 595",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327780595",
            "telephone_number": "352-551-3263",
            "fax_number": "352-589-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37640 QUAIL RIDGE CIR",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347888117",
            "telephone_number": "352-551-3263",
            "fax_number": "352-589-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN ARMS MED WAIVER PROVIDER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "SCHLISSIO",
        "authorized_official_first_name": "ANTONY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "352-551-3263",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "677896898",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "677896896",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providers in Leesburg, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.