Provider Demographics
NPI:1992262851
Name:ARMS OF JESUS
Entity type:Organization
Organization Name:ARMS OF JESUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARLEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:OHAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-600-2367
Mailing Address - Street 1:3424 SE 146TH PL
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-3970
Mailing Address - Country:US
Mailing Address - Phone:502-600-2367
Mailing Address - Fax:
Practice Address - Street 1:3424 SE 146TH PL
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491
Practice Address - Country:US
Practice Address - Phone:502-600-2367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing PersonnelGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1929Medicaid
FL1928OtherANY